Those Bogus Cancer Cures

One of those emails dropped into my inbox a few days ago. It had been several months since the last one – swearing that megadoses of vitamin C would cure my cancer.

Before that, other TGB readers had declared to me that biomagnetism (whatever that is), bee venom and the ever-popular extract of apricot pits would cure my cancer.

And in case I was suspicious, they each said they know the particular cure they were touting works because their (mother, father, cousin, best friend, pick one) – has been free of cancer for five or six or 20 or whatever number of years.

Yeah, right.

In recent years, new cancer treatments have come along some of which, immunotherapy, hormone therapy, targeted drug treatment, cryoablation among others, show promise. But no one is curing cancer wholesale yet.

After confirming pancreatic cancer, the doctor explained that the only treatment was surgery, the Whipple procedure, followed by chemotherapy. Without it, he said, I would be dead within a few months.

It is a terrible, intrusive surgery that would last 12 hours or more, the doctor said, but that I was a good candidate for it: the cancer was contained in one end of my pancreas; I was, especially for my age, in excellent physical shape, and had no other medical issues.

I took a night to sleep on it before making a decision.

It's hard to think in that situation - having been told you have a kind of cancer that kills about 90 percent of people who are diagnosed with it - and it doesn't fool around like some slow-growing cancers people can live with for many years.

Pancreatic cancer was not a mystery to me. My father had died of it 35 years previously so I had a fair bit of familiarity with it – none of it good.

The will to live, I discovered over that night, is extraordinarily strong. And so the next day, I told the surgeon I would “do the Whipple,” as it were, and it was scheduled for three weeks hence.

After I wrote about the diagnosis and upcoming surgery, I received an email from a reader recommending a certain alternative treatment. He or she (I don't recall which) was insistent that this worked, that he/she knew people whose cancer had been cured and etc.

Of course, I dismissed the email as ramblings of an idiot. If there were a cure for cancer, we would all know about it. It is one of life's mysteries – at least to me - why so many people don't get that. But the email did force me to think carefully about how I wanted to deal with my cancer.

For being such a momentous decision – literally life and death – I was surprised at how easy it was.

I was being treated at a medical center than includes five hospitals, a medical school, a research center and much more. A whole lot of people working in the oncology department there had seen a whole lot more cancer than I ever would.

So it wasn't a leap to decide that I would follow the doctors' instructions. Carefully. And I have done that. Now, nearly two-and-a-half years since diagnosis I'm still here and in relatively good daily health – neither of which I expected by this date. So I believe it has been a good decision.

It's not that I entertained for a moment such bogus “cures” as are sold on professional-looking websites that nevertheless occupy some of the darker corners of the internet.

Plus, I doubt that either private insurance or Medicare pays for this kind of treatment so it would be out of the question for me anyway. I'm too poor.

But the bigger issue than me is how many people diagnosed with a terrible disease are desperate enough to try such so-called cures. The websites never say “out loud” that they cure cancer but like those cancer center commercials on television, all are designed to activate our “miracle” gene.

I'm pretty sure if miracles were happening from any of these regimens, they would be sure to tell us.




ELDER MUSIC: Classical – By the Numbers

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

* * *

Today we’re eschewing the orchestra and having music from small ensembles. I’m going from one to ten, and we’ll see where that gets us. With the lower numbers I’m overwhelmed by choice, but as the numbers increase, the tracks pretty much choose themselves as there aren’t too many options.

Okay, instead of counting down, I’m counting up, starting at one.

ONE
I don’t know if you really call one an ensemble but I’m including it nonetheless. For one, it’s either a piano sonata (sonatas for other instruments always include a piano or other keyboard instrument, so for this exercise they really count as two) or a suite for a single instrument.

I kept going back and forth between a Beethoven sonata and a Bach English suite. In the end I settled for LUDWIG BEETHOVEN.

Beethoven

His piano sonatas are the high point of music for this instrument; no one has done it better. He wrote a whole bunch of them and I chose one that’s not as well known as the famous ones. This is the first movement of Sonata No 9 in E major, Op. 14, No. 1, played impeccably by Gerard Willems.

♫ Beethoven - Sonata No 9 in E major Op. 14 No. 1 (1)


TWO
WOLFGANG MOZART wrote a series of works variously called violin sonatas or sonatas for violin and piano.

Mozart

As far as I can tell these are essentially the same sort of thing and I’m using one of those today. In this case it’s called the Sonata for Piano and Violin in G major, K 301, and we have the second movement. It’s played by two of the best in the business, Itzhak Perlman on violin and Daniel Barenboim on piano.

Mozart - Sonata for Piano and Violin in G major (2)


THREE
Joseph Haydn invented the piano trio, and Mozart took it up and ran with it. Initially, it sounded more like a mini-piano concerto, but by the time Schubert got to it, all the instruments (piano, violin, cello) began to receive equal billing.

Probably the finest of all, and there’s a lot of competition, is the one by FANNY MENDELSSOHN, Felix’s big sister.

Fanny Mendelssohn

Felix always contended that she was a better composer than he was, and that’s a big call, but as more of her compositions are discovered, it’s easy to see that there’s some justification for his point of view.

Here is the second movement of her Piano Trio in D minor, Op 11.

♫ Fanny Mendelssohn - Piano Trio in D minor (2)


FOUR
Three, four and five are where all the quality music is. As well as inventing the piano trio, JOSEPH HAYDN also invented the string quartet, and it’s appropriate we feature one of his.

Haydn

That’s Jo himself instructing some others how he wants his music played. Although they weren’t his first, the six string quartets that make up his Opus 20 are the ones that gained him the reputation as father of this musical style.

One of those is the String Quartet in C Major, Op.20 No.2, the first movement.

♫ Haydn - String Quartet in C Major Op.20 No.2 (1)


FIVE
Normally I’d put Mozart here with his clarinet quintet, but I’ve already featured him above so I thought we should have someone different, someone nearly as good as the great man, CARL MARIA VON WEBER.

Weber

Like Mozart’s, his clarinet quintet is still regularly performed and recorded to this day. Listening carefully to it, it’s obvious that he lent an ear to Wolfie’s. Learn from the best is good advice.

This is the fourth movement of his Clarinet Quintet in B flat major J 109.

♫ Weber - Clarinet Quintet (4)


SIX
IGNAZ PLEYEL was far and away the most famous composer of his time.

Pleyel

In retrospect, this might seem unusual as his time encompassed Boccherini, Beethoven, Hummel, the latter years of Haydn and many others. Like some other famous (at the time) composers, he quickly slid from view and only a few appreciate him these days.

He was a workaholic, writing hundreds of compositions. He was also a businessman, creating a publishing company that published just about everyone composing at the time. Besides all that, he created a company that made probably the best pianos around, and it continues to this day.

Getting back to the music, this is the first movement of his Sextet in E flat major.

♫ Pleyel - Sextet in E flat major (1)


SEVEN
Just imagine what JOHANN NEPOMUK HUMMEL’s address book was like.

Hummel

He lived with the Mozarts for a couple of years and was taught by Haydn, was good friends of both Beethoven and Schubert. He taught Mendelssohn and was also good friends with Goethe. Jo also composed quite a bit of music including the Piano Septet No. 1 in D minor, Op. 74. This is the second movement.

♫ Hummel - Piano Septet No. 1 in D minor Op. 74 (2)


EIGHT
Felix Mendelssohn deserves this spot for his extraordinary Octet for strings in E flat major, Op. 20 which he wrote at age 16. However, he is featured down below, so we have someone else in his place. In spite of his name, PETER WINTER was a German composer.

Peter Winter

In terms of style and age, he fits neatly between Mozart and Weber. During his lifetime he was a wildly successful opera composer, one of which was a continuation of the story of Mozart’s “Magic Flute”. None of his operas are performed these days.

He graces our column today for his Octet for Winds and Strings, the third movement.

♫ Winter - Octet for winds and strings (3)


NINE

LOUISE FARRENC was born Louise Dumont in Paris and showed musical talent at a young age.

Farrenc

She began studying at the Paris Conservatoire at age 15. Later she met and married Aristide Farrenc, a flute player of some note and the two toured playing flute and piano.

Ari tired of the performing life and started a music publishing company which proved a boon for his wife. Louise initially only wrote music for the piano but after some years branched out into larger works, one of which is her Nonet for Strings and Wind in E-Flat Major, Op. 38. Here is the third movement.

♫ Farrenc - Nonet for Strings and Wind in E-Flat Major Op. 38 (3)


TEN
There’s been a change of plans. Originally I had an arrangement of a part of Mendelssohn’s Midsummer's Night Dream for dectet. After playing it several times, I decided to throw it out as it wasn’t very good. Indeed, it was awful. Not Felix’s music, the arrangement is what was so jarring.

In its place we have JEAN FRANÇAIX with his Dixtuor for Wind Quintet and String Quintet.

Françaix

He cheated a bit as it’s not quite a dectet, it’s a wind quintet and string quintet cobbled together – well, there are ten of them. This is the third movement.

♫ Françaix - Dixtuor for Wind Quintet and String Quintet (3)


Ten is pretty much as far as we go. There are a couple of works mentioned on the web for hendectet or undectet, which are both for eleven instruments but I don’t have any of those. Generally after ten, ensembles are just called orchestras or bands or something.

Since I threw out FELIX MENDELSSOHN, and up above I said that he deserved to be at the number eight spot, I thought I’d have him back in as a bonus.

Mendelssohn15

As I mentioned, this is his Octet for strings in E flat major, Op. 20, the first movement. Sit back and let the music float all around and over you.

Mendelssohn - Octet Op 20 (1)




INTERESTING STUFF – 19 October 2019

WE LOST A GREAT MAN THIS WEEK

You cannot have missed the news that Congressman Elijah Cummings died this week at age 69. Too young, too young.

There are many heartfelt obituaries and memories of him around the web – just google his name. This is part of a statement from his wife, Dr. Maya Rockeymoore Cummings who is the chair of the Maryland Democratic Party:

“Congressman Cummings was an honorable man who proudly served his district and the nation with dignity, integrity, compassion and humility.”

“He worked until his last breath because he believed our democracy was the highest and best expression of our collective humanity and that our nation’s diversity was our promise, not our problem,” she added.

“It’s been an honor to walk by his side on this incredible journey. I loved him deeply and will miss him dearly.”

And there is this – part of his first House floor speech in 1996:

May be rest with the angels.

CAN VERTICAL FORESTS HELP CLIMATE CHANGE?

The world is going to need many thousands of good ideas to thwart climate change. Maybe this is one of them – a building in Milan now five years old. What if big cities were full of buildings like this.

VICTOR THE EAGLE DOCUMENTS CLIMATE CHANGE

The YouTube page tell us that

”A white-tailed eagle named Victor has completed five flights over the Alps to promote action on climate change. Breathtaking footage of the flights over Germany, Austria, Italy, Switzerland and France was filmed with a 360° camera mounted between the bird’s wings.

“EagleWings Foundation, who organised the flights, aim to raise awareness on climate change by highlighting the melting of Alpine glaciers. Some 250,000 cubic metres of ice are in danger of collapsing from the Planpincieux glacier on the Grandes Jorasses peak, in the Alps near Chamonix and Courmayeur.”

HOW THE INTERNET WORKS

I sort of knew this but had forgotten some of it. This video from 2013 follows a “packet” from your fingertips to the host server and back again in less than a second.

AN IRISHMAN'S FUNERAL JOKE

You may have heard this week about the Irishmen who decided to give his friends a good laugh when they gathered to send him off into eternity. Fortunately for us, someone video-taped it.

There is more of the story at Huffington Post.

HOW MUCH IS DEMOCRACY WORTH?

Well, not really but I couldn't resist. It's actually about what the democracy.com domain is worth. It goes on auction under sealed bids on 25 October. The Guardian tells us that

”According to the domain brokerage GoDaddy, the five most expensive publicly reported domain names are CarInsurance.com – $49.7m; Insurance.com – $35.6m; VacationRentals.com – $35m; PrivateJet.com – $30.18m; and Voice.com – $30m. Sex.com sold for $14m and Porno.com – $8.8m.”

Read more at The Guardian.

THE DOG PHOTOGRAPHER

You are likely to have heard of dog photographer William Wegman. He has been photographing his succession of Weimaraners for 45 years. As the YouTube page tells us,

”His work is at measures droll and enchanting, evoking awe in audiences around the world. And, his pups have had their share of the limelight, making appearances on everything from Saturday Night Live and Sesame Street to movies and galleries worldwide.”

Not to mention an interview I produced (I've forgotten the name of the show) with Wegman and two of his dogs in about 1974 or 1975. The host of that show was Matt Lauer long before he ascended to The Today Show and the more recent debacle that concluded with his resignation.

But that doesn't take away from Wegman's dog's charms.

A BABY OCTOPUS IN A PLASTIC CUP

Pall Sigurdsson tells us on the YouTube page:

”We spent a whole dive and most of our air saving this octopus from what was bound to be a cruel fate. The coconut octopus, also known as veined octopus, is born with the instinct to protect itself by creating a mobile home out of coconut or clam shells.

“This particular individual however has been trapped by their instincts and have made a home out of a plastic cup they found underwater.

“While a shell is a sturdy protection, a passing eel or flounder would probably swallow the cup with the octopus in it, most likely also killing the predator or weakening it to a point where it will be soon eaten by an even bigger fish.

“We found this particular octopus at about 20 meters under the water, we tried for a long time to give it shells hoping that it would trade the cup. Coconut octopus are famous for being very picky about which shells they keep so we had to try with many different shells before it found one to be acceptable.”

YOU'VE GOT A FRIEND IN ME

From my friend Jim Stone. No explanation needed for such a sweet video. Just enjoy.


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Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog.




Sleeping – or Not – While Old

Until about 18 months ago, most nights I slept for about four hours; five hours when I was lucky. There was a time, more than a decade ago, that an evening dose of melatonin kept me asleep for the more traditional seven or eight hours and I felt so much better then.

But after a couple of years it stopped working.

I got by as I always had, toughing it out during the day when there were things that must be done. I was slow to twig to the fact that I now live in a state where cannabis (that's what we're supposed to call it now – I still think of it as weed or pot) is legal.

About a year-and-a-half ago, I began using a tincture of cannabis which kept me asleep all night, seven or eight hours, until it didn't anymore. Both a dispensary “budtender” and one of my physicians said that often, sleep aids of all kinds can stop working and suggested I try alternating types of cannabis. So now I use a gummy in between the tincture.

It's been working for me. Some friends have had less success. (I always use THC cannabis; CBD does nothing for me in regard to sleep.)

Insomnia is serious but common problem for old people. Even when sleep disorders such as restless leg syndrome, sleep apnea, pain or certain medications are discounted, about one-third of people 65 and older don't get enough sleep according to a 2017 University of Michigan poll.

Today's post is not about medical conditions that cause sleep disorders but I want to pass on what the National Sleep Foundation says about sleep apnea:

”...untreated sleep apnea puts a person at risk for cardiovascular disease, headaches, memory loss and depression. It is a serious disorder that is easily treated.

“If you experience snoring on a regular basis and it can be heard from another room or you have been told you stop breathing or make loud or gasping noises during your sleep, these are signs that you might have sleep apnea and it should be discussed with your doctor.”

Note that phrase, “serious disorder that is easily treated.” How often does anyone tell us that? So if you suspect sleep apnea or any other medical cause of insomnia, get thee to your physician.

When there is not an underlying medical reason for sleeplessness, there are other reasons it happens. WebMD tells us, there is

”...a big difference between younger and older sleepers: the timing of rest. As adults age, advanced sleep phase syndrome sets in, causing the body's internal clock to adjust to earlier bed and wakeup times. But some seniors continue to stay up late, as they did in their younger years. Sleep deprivation is often the result.”

Every source I read tells us that it is a misconception that people need less sleep as they age. Research shows that sleep need remains constant throughout adulthood – seven or eight hours.

Assuming there is no underlying medical reason you can't sleep or can't sleep enough, what's an insomniac elder to do?

There are always the prescription sleep potions, right? Ambien, Lunesta, etc. In an excellent article about elder sleeplessness, Consumer Reports warns against them noting that one analysis found that people using these drugs

”...fell asleep only 8 to 20 minutes faster than people taking a placebo.

“Taking sleep meds may also cause dependency and increase your risk of car accidents, and more than double your risk of falls and fractures, common causes of hospitalizations and death in older adults, according to Consumer Reports’ Choosing Wisely campaign.

“Because of these dangers, the American Geriatric Society includes the more potent prescription sleep drugs—eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)—on its list of medications that adults age 65 and older should avoid.”

This can be true of some over-the-counter sleep aids too. And if you would be inclined to try cannabis, what if you don't live in a place where it is legal? There is no dearth of advice around the web. This is one of the better lists of useful techniques. From WebMD:

⏺ Get set. Wake up at the same hour every day and exercise and eat meals at set times to help get sleep back on track.

⏺ Get Exercise. Check with your doctor to see what type of activity is best for you, and then get out and do it. You might want to do it early in the day, though, so it doesn’t keep you up at night. A little sunlight each day can make a big difference too!

⏺ Get Cool. Keep your bedroom on the cool side. And turn off all those lights and electronics. Keep the TV out of the bedroom.

⏺ Get a Routine. Anything that relaxes you—a warm shower, a few moments of meditation, a good book.

⏺ Get Out of Bed. That’s right! If you are tossing and turning after about 10 or 15 minutes, get out of bed and do something relaxing. Just don’t turn on that TV or computer.

⏺ Get checked. Some medication or certain medical problems can interrupt sleep. If a medication is to blame, your doctor can recommend adjusting the timing or dose, or possibly switching to an alternative prescription. And if it’s a medical problem that’s stealing away your shut eye, she can address that, too.

There is another list from helpguide.org – a much longer list than above – that may be helpful.

The reason you're reading this today is that the cannabis, even with two delivery systems, has stopped working for me. Well, it's been only since Monday and maybe it is just a short-term anomaly, so I'm going to give it some more time before figuring out something new.

But in case I need it, I tracked down all this information so I'm passing it along to you.

I'm sure we would all like to hear about your own adventures in sleep – or not - too. Just remember that you may recommend NO PRESCRIPTION DRUGS nor any other treatment except in the context of what has worked or not worked for you. And no links.




Old Age and Loneliness

It has been known for years now that loneliness can be devastating to the health and well-being of old people. According to a report from the National Poll on Healthy Aging at the University of Michigan published earlier this year,

”Research shows that chronic loneliness can impact older adults’ memory, physical well-being, mental health, and life expectancy. In fact, some research suggests that chronic loneliness may shorten life expectancy even more than being overweight or sedentary, and just as much as smoking.”

Other reports have found that one-third of American elders are lonely. More women say they are lonely than men and living alone has a high correlation with loneliness.

The people who hand out advice online tell us that loneliness can be relieved by what has become a fairly standard list of prescriptions that includes volunteering, joining a tai chi class or a choir, practicing gratitude or adopting a pet. One list of this type includes buying an Amazon Echo to talk with.

Uh-huh.

Undoubtedly, much younger people are the ones making these lists. They don't often take into account such things as physical limitations or transportation difficulties, for example. Further, all the studies I've looked at assume that any person who says he or she is lonely, even those who choose the “sometimes” answer, are miserable about it.

News flash: I feel lonely sometimes. I have felt lonely sometimes throughout my life. Usually I can move on after a good night's sleep.

What has become clear in my case over the years is that I need a lot more time alone than many people I have known. No one who studies loneliness seems to have considered the fact that some of us enjoy our own company a great deal of the time.

None of that is to say that loneliness is not painful, hard to live with and often associated with depression. And old people have the added difficulty that if you live long enough, a lot of the people who mean the most to you, who you may have known for decades, die.

Sometimes I wonder if one of the reasons I enjoy keeping in touch with my former husband is that he is the last human on earth who knew me when was 17. There is comfort in that.

For a story about elder loneliness last March, Time magazine interviewed Dr. Carla Perissinotto, associate chief of clinical programs in geriatrics at the University of California San Francisco:

“She says loneliness refers to 'the discrepancy between actual and desired relationships' — so it’s possible that someone who lives alone doesn’t meet that definition, while someone in a house full of busy people does. 'It gets to the quality of the relationship,; she says.

“Perissinotto says it’s important to address each person’s underlying cause of loneliness, whether it’s the death of a spouse, medical problems that make it difficult to socialize or leave the home or unmet social expectations.

“Doing so takes 'understanding and being honest with yourself about whether you could be experiencing loneliness,; Perissinotto says.”

There is at least one place in the world that has done more about elder loneliness than any of those lists could. I was alerted to it by TGB reader John Gear.

This short video explains clearly what has been happening in Frome, England, after a doctor there created a system in which loneliness is treated as a medical condition. Take a look:

I'm not sure that the same approach would work everywhere but a good start would be to make loneliness an integral part of healthcare, something physicians, nurses and other healthcare professionals ask patients about. Of course, the hard part comes next - finding ways to help. I suspect what works in a small town would be difficult in larger cities.

What do you think?




A TGB READER STORY: Carole's Debate

By Carole Leskin

"You are old", says the voice in my head.
"You have many years left", says my beating heart.

"You are slowing down - it's to be expected", says the voice in my head.
"You have so much left to see and do", says my beating heart.

"You must prepare for the limitations to come", says the voice in my head.
"You should be open to new opportunities and adventures", says my beating heart.

"You must act your age - let your hair grow gray", says the voice in my head.
"You should do as you please", says my beating heart.

"You must be strong and self-reliant", says the voice in my head.
"You should not hesitate to ask for help when you need it", says my beating heart.

"You must be ever vigilant for it is a dangerous world", says the voice in my head.
"You should welcome and be grateful for the kindness of strangers", says my beating heart.

"You must learn to live with loss", says the voice in my head.
"You should view each day as a new beginning", says my beating heart.

"You must come to terms with the Inevitability Of Death", says the voice in my head.
"You should find Purpose and Joy in Life", says my beating heart.

The debate is intense. When it concludes, who is the winner? My head or my heart?

Can both be right?

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[EDITORIAL NOTE: Reader's stories are welcome. If you have not published here or not recently, please read submission instructions. Only one story per email.]




Annual Medicare Enrollment Period has Arrived

EDITORIAL NOTE: This is so far from comprehensive as to be a joke but I hope it will give you an overview of the basics of Medicare and how they apply in the annual enrollment period.

Because this post is longer than usual, I've used bolding and lists to make it easier to navigate and get to the sections that interest you most.

* * *

It's that time again – Medicare Annual Open Enrollment begins tomorrow, 15 October, and lasts through 7 December. During this period of 54 days you can:

⏺ Switch from traditional Medicare to Medicare Advantage (MA)

⏺ Switch from Medicare Advantage to original Medicare

⏺ Select a different Medicare Advantage plan if you have one now

⏺ Enroll in a Part D prescription drug plan

⏺ Change to a different Part D plan if you already have one

If you are new or newish to Medicare, it can be daunting. Medicare is a massive program and I'm pretty sure that even people who are certified to help the rest of us figure it out don't know all of it.

In that regard, there is a short list of links at the bottom of this post for more detailed or personalized information.

Here are the various Medicare parts:

Part A: Part of traditional Medicare, it covers hospital and hospice care along with some skilled nursing services after a hospital stay. There is no premium for Part A.

Part B: Part of traditional Medicare, it covers doctor visits and certain outpatient services. The Part B premium is deducted from your monthly Social Security payment and will be about $144.30 in 2020, up from $135.50 in 2019. The exact amount has not been announced yet.

Parts A and B constitute traditional Medicare. You may choose any doctors who accept Medicare.

Part C: Medicare Advantage (MA), issued by private insurance companies, is required to include traditional Medicare Parts A and B (at the same premium as traditional Medicare) and often includes Part D along with limited coverage for vision and dental care, for example.

MA takes the place of traditional Medicare. (Some companies charge no premium.) You are restricted to their network doctors.

Part D: Helps pay for prescription drugs. Part D is private coverage for which you pay a separate monthly premium if you have traditional Medicare.

Medigap: Also called Medicare Supplemental, is private coverage that helps pay for what Medicare does not, such as co-payments, co-insurance and deductibles. Restrictions apply as to who can buy Medigap coverage and when.

MEDICARE AND YOU HANDBOOK
The Medicare and You Handbook has many explanations and answers. You can download an electronic copy online. There is a wide choice of editions: PDF, large-print PDF, ebook for your Kindle, iPad, etc. You can also telephone to have a CD audio version, a Braille version or the paper edition mailed to you.

The telephone number is 800.633.4227 or visit the webpage.

This booklet is well organized, clearly written and as easy to use as anything related to Medicare can be.

MY MEDICARE
The official Medicare website is at medicare.gov. Check the dropdown menus at the top of the page for many specific questions.

If you have not signed up for My Medicare which personalizes the Medicare website for you, you can do that on this page. It can help a lot.

When I signed in to My Medicare to check my Part D coverage a couple of days ago, all my current prescriptions were already listed for me – names, dosages, quantities for each refill, and frequency of refills. All of it was correct.

If any of my prescriptions had changed, this is were I could edit them or add and subtract drugs as needed.

In my state, there are 28 Part D plans available, most with a deductible. With just a mouse click, I could see details of each plan and select up to three-at-a-time to compare with one another and check that my drugs are still covered.

That's important. It can change from year to year and, of course, each company's formulary is unique to it.

A recent mailing from that plan advised me that if I wish to continue for 2020, I don't need to do anything. My plan will roll over to next year.

You can also check drug prices of plans at several pharmacies near you and at mail-order pharmacies.

It took me about two hours to work through all the information and make my choice. I use seven prescription drugs. If you have more, it will take longer but the interface makes it relatively easy with one caveat: the plan finder is newly updated and may contain some glitches.

The above applies only to Part D in connection with traditional Medicare. If you have Medicare Advantage or are switching to it, you're on your own. MA is a mystery to me but Medicare's MA Plan Finder works similarly to the Part D Plan Finder.

PERSONAL SUGGESTION NO. 1: If you do not use any prescription drugs, choose the least expensive plan. Since there is no way to predict what might go wrong and therefore what drugs you would need, nothing else makes sense.

When I was diagnosed with cancer and began using prescription drugs, there was one not covered by my plan. Fortunately, it was not too expensive but in the next enrollment period, I chose a Part D plan that covered all my drugs.

(Yes, it is a stupid idea to make people choose a plan when they don't know what they will need it for. Complain to your representatives in Congress.)

PERSONAL SUGGESTION NO. 2: I was prescribed a new inhaler this year. When I was told my part of the price, I nearly passed out – about $500 per month. I told the pharmacist that was out of the question and prepared to see what else the doctor could recommend.

But the pharmacist told me that drug companies will reduce the price considerably in many circumstances, that I would need a declaration signed by my physician and that they, the pharmacy, would take care of all the paperwork.

In less than a week, the drug company approved me and the price dropped to just over $100. So if the price is high, ask what can be done. Pharmacists are well informed and helpful.

WHAT'S NEW IN MEDICARE FOR 2020
Medicare Advantage may now cover such items grab bars, rides to and from medical appointments, acupuncture, massage therapy and more. They are offered at the plan's discretion and only for certain health conditions. This applies only to Medicare Advantage and not to traditional Medicare.

At last, the Medicare Part D doughnut hole (coverage gap) goes away completely in 2020. However, the new limit for out-of-pocket expenses increases from $5100 in 2019 to $6,350 in 2020. Part D plan members will now pay 25 percent of the cost of generic and brand name drugs.

Once you have reached that $6,350 threshold, you pay five percent of a drug's cost.

WHERE TO FIND PERSONALIZED MEDICARE HELP
You can get personalized help as you ponder your open enrollment decisions.

MEDICARE
Medicare.gov has an online chat feature available during open enrollment, and the Medicare hotline, 800-MEDICARE (800-633-4227), is open 24 hours a day, seven days a week during the annual enrollment period.

SHIP (State Healthcare Insurance Assistance Program)
These state-based organizations offer help with Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance along with help for joining or leaving a Medicare Advantage Plan, any other Medicare health plan, or Medicare Prescription Drug Plan (Part D).

Locate a SHIP representative in your state here.

Another SHIP list by state from Seniors Resource Guide. This list is up to date as of October 2019.




ELDER MUSIC: Johnny Cash

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

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Johnny Cash

For those who have been living on Saturn for the last 60 or 70 years, JOHNNY CASH was one of the most important musicians in country, pop and various other genres of music during that time. He was also an advocate for Native American rights and prison reform, amongst other things.

He was a good man and occasional bad boy in the one distinctive package. There’s too much that happened in his life for me to tell you here, so we’ll just get to the music. Out of his many hundreds of songs, I’m sure I’ve omitted your favorites. These are the ones I think deserve to be present.

I’ll start early (but not the very earliest) with the song Guess Things Happen That Way. It was written by Jack Clement and it made the pop charts as well as the country ones back in 1958.

John had a few hits before this one which could just as easily have begun this column.

♫ Guess Things Happen That Way


Johnny Cash & Ten Two

Norma, the Assistant Musicologist, insisted that the next song be present. It was going to be anyway but she just added some weight to that.

I’ve always assumed that the Tennessee Flat Top Box was one of those early twentieth century Gibson acoustic guitars so prized by aficionados of such instruments, of whom I assume John was one as he wrote the song.

♫ Tennessee Flat Top Box


The Statler Brothers were one of the finest harmony groups in country music, if not the best of the lot. John started them on the road to success by having them as part of his touring band. Not just that, he had them backing him on recordings as well.

Here they are on Daddy Sang Bass, with Jan Howard (not June Carter, as is often suggested). The song was written by Carl Perkins.

♫ Daddy Sang Bass


JohnnyCash33

Ira Hayes was an American war hero; he fought in Bougainville and in the two Iwo Jima campaigns. Indeed, he was one of the marines who famously raised the flag on Mount Suribachi on Iwo Jima.

However, he was a Pima Indian and he was treated disgustingly by the government and the people upon his return. I’m not just saying that to make a point about American’s treatment of their original people, the same thing happened in Australia to our Aborigines. It was shameful of both our countries.

Here is The Ballad of Ira Hayes, written by Peter La Farge.

♫ The Ballad of Ira Hayes


Johnny Cash

Towards the end when none of the major record companies would touch him, Rick Rubin asked John if he’d like to have him as a record producer, and release his records through his label.

This was somewhat unusual, as Rick was best known at the time for producing hard rock and hip hop artists. He was a fan of John’s though, and he went on to produce half a dozen albums that stand as some of the most interesting of John’s career.

His voice may not have the power and quality it had when he was younger but there's no doubting his integrity. It's a man who's seen everything, done everything and never compromised.

Here is the appropriately named A Singer of Songs.

♫ A Singer of Songs


Johnny Cash

There are stories that John spent time in prison. He didn’t, at least not involuntarily. He did spend a lot of time performing, entertaining the inmates. He made a couple of famous albums at such places – Folsom and San Quentin Prisons.

The song Folsom Prison Blues was originally recorded in 1955 and it was used extensively as his opening song in concerts. This was especially so at Folsom Prison where it went over like gang busters. Here’s the original version.

♫ Folsom Prison Blues


Bill really should have listened to his mum when she advised him Don't Take Your Guns to Town. Naturally, he was young and stupid and didn’t listen. You can guess, or already know, the outcome.

♫ Don't Take Your Guns To Town


Johnny Cash

Eric Von Schimdt wrote the song Joshua Gone Barbados, and he recorded a fine version of it. The definitive version is by Tom Rush. John recorded the song as well with some help from Hoyt Axton. It’s certainly up there with the previously mentioned ones.

There are conflicting stories about the accuracy of the song. Some contend that Ebenezer Joshua was a hero on the island, others that he was a villain. There’s no dispute about Sonny Child though. I imagine that the legend will outlive the truth. It’s a good song though.

♫ Joshua Gone Barbados


Johnny Cash

James Garfield was the second American President to be assassinated. He didn’t die immediately and he probably wouldn’t have died at all if the doctors at the time didn’t fiddle around in his insides with their filthy hands; they didn’t hold with this sterilisation nonsense.

The shooter in this instance was Charles Guiteau. John tells us all about this in Mr Garfield.

♫ Mr. Garfield


Johnny Cash

Here is another song from very late in his career, and John’s voice is really cracking but there are few people who record with the dignity and integrity that he displays on this song.

It’s Four Strong Winds, written by Ian Tyson, a writer (and singer) of superb songs.

♫ Four Strong Winds


Johnny Cash

I’ll end with what I consider the high point in John’s canon; I think the finest song he recorded. That’s a big statement, given the quality of the songs both included here and the many great ones I left out.

This was written by Bruce Springsteen and is on his extraordinary “Nebraska” album. Bruce does a fine, if rather low-key, version on that disk and for once I prefer the cover. It almost seems as if he wrote the song with John in mind. It is Highway Patrol Man.

♫ Highway Patrolman




INTERESTING STUFF – 12 October 2019

WHEN ELIZABETH WARREN WAS ASKED ABOUT MARRIAGE EQUALITY

Last Thursday evening, CNN held an equality town hall with the Democratic presidential candidates. Elizabeth Warren was asked about marriage equality and she knocked it out of the park. Take a look:


CATS IN THERAPY

When cats need a shrink...


THE ALEX AND RONNI SHOW

Here's the latest episode of the bi-weekly chats with my former husband, Alex Bennett. This one was recorded last Tuesday.


SOCIAL SECURITY COLA FOR 2020

The Social Security Administration announced this week that the 2020 cost-of-living (COLA) increase for most Social Security beneficiaries will be 1.6 percent. Investment News noted that

”In 2020, individuals will be able to earn up to $18,240 per year if they are under full retirement age for the full year without forfeiting any benefits. That's up from $17,460 this year...

“The latest Medicare Trustees' report projects that basic Medicare Part B premiums will increase by about $8.80 a month to $144.30 per month in 2020. The official announcement about Medicare premiums for 2020 will be issued later this year.”

The Part B premium is deducted from the monthly Social Security benefit.


CHINA'S GIGANTIC ROAD NETWORK

China has more roadway than any other country in the world – 84 thousand miles including a bridge that is 34 miles long. This is amazing to see:


MAGIC MEERKAT MOMENTS

Meercats are the cutest little animals and a few BBC cameramen got some up close and personal fun with them. Flixxy, where I found this video, tells us,

”After being studied for years, the small mammals have no fear of humans, and simply treat them as a part of the scenery.

“The meerkat is a small mammal belonging to the mongoose family. Meerkats live in all parts of the Kalahari Desert in Botswana, in much of the Namib Desert in Namibia and southwestern Angola, and in South Africa. A group of meerkats is called a 'mob', 'gang' or 'clan'".


AN ASTONISHING BEACH CLEANING CAMPAIGN

I am thrilled when I find what individuals are doing to help the planet. Take a look at this one:

If groups of us everywhere got together, we could do this cleanup part. Easy.


PSILOCYBIN REPORT ON 60 MINUTES

As many of you know, last December I took a psilocybin (magic mushrooms) session with a guide in an effort to make peace with the fear of dying that was crippling me after I had been handed a death sentence due to pancreatic cancer.

It worked. I can't say I am completely sanguine about dying, but I am a lot more comfortable with it and now see death as part of a larger phenomenon.

Throughout this year since my session, the medical community has been showing more and more interest in how psychedelics can help treat PTSD, anxiety, pain and many other conditions. Next year, legalization of psilocybin for therapeutic use in on the ballot in Oregon, in Denver and perhaps a few other locations.

This Sunday, tomorrow, the CBS News program 60 Minutes will present a segment about psylocybin. TGB reader Gary G. Trabucco sent this item for us including a trailer for Sunday's report:

Almost simultaneously, I found out about this feature-length documentary, Fantastic Fungi – The Magic Beneath Us. It's about fungi in general but also includes information about psychedelic mushrooms. (Even if you don't care about fungi, you should watch this for the stunning photography.)

Dates and venues for theater screenings of the documentary in the U.S. are listed at the film's website.


DOG RESCUED ONE MONTH AFTER HURRICANE

A full month after Hurricane Dorian killed an estimated 50 people and devastated the Bahamas,

”A drone flew over the wreckage, using an infrared camera to try to identify heat — a sign of possible life hidden amid the rubble," reported the Washington Post.

“Then, the drone operated by Florida-based shelter Big Dog Ranch Rescue sensed heat. A volunteer trudged more than half a mile over debris to where an air-conditioning unit and piles of metal had trapped the survivor: a 1-year-old mixed-breed puppy.”

The Washington Post continues:

”The dog had survived only on rainwater that filled a hole in front of him after the hurricane, so rescuers gave him some fluids to stabilize him before the hour-long flight [to Florida].

“When he arrived at Big Dog Ranch, Simmons said, his muscles had wasted away from a month of immobility and his body weight had plummeted from about 45 pounds to 22 pounds.”

The rescuers named him (her?) Miracle.

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Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog.




Crabby Old Lady Faces Cancer Season

They're at it again, the media is, especially television. Apparently, fall is cancer season. Everywhere Crabby Old Lady clicks her remote, there are commercials for cancer.

With five hospital and five outpatient locations around the U.S., Cancer Treatment Centers of America (CTCA) is only the most ubiquitous. There are plenty of other cancer treatment centers that advertise mainly in the cities or states where their single facility is located. St Judes, the well-known children's cancer research hospital located in Memphis, advertises nationally.

But it doesn't stop there. Individual cancers have their own commercials for societies, foundations, associations, etc. that provide certain medical services and support for those who are diagnosed.

Recently, Crabby has seen such commercials for the Breast Cancer Foundation, the American Cancer Society and the Skin Cancer Foundation.

And then there are the commercials for less well-known, local treatment centers. These often star survivors - especially those who have survived more than one cancer - telling their stories.

At least one treatment center is not so eager to shout cancer, cancer, cancer from our screens. M.D. Anderson seems to have changed its name recently to M.D. Anderson Center:

At M.D. Anderson, the YouTube page tells us, you're considered a survivor the moment you receive a cancer diagnosis. (Wow. From disease to remission in one little twist of language.)

Crabby Old Lady does not for a minute buy that bit of doublespeak meant to put a happy face on cancer.

As she may have mentioned in the past, Crabby has become a master manipulator of the mute button on her TV remote. She wields it in a matter of a second or two when she hears President Trump's voice on television because she finds it and his lies so repellent.

This time of year, she adds the word “cancer” to her mute button skills. It's enough to be living with cancer every day - Crabby doesn't need to be reminded by all those bright, shiny, smiling people behaving as though cancer is the best thing that ever happened to them.

It is not. Not ever. Cancer is the hardest thing Crabby Old Lady has ever been through and she has it easier than a lot of cancer patients.

All those smiles in the commercials are meant to suggest that this or that treatment center knows how to cure cancer better than another center. Listen to Crabby: if there were a cure for any kind of cancer, we would not be hearing about it first in a television commercial.

Or maybe Crabby missed that announcement when she muted her remote.