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A welcome change in the federal “smoking age”.

https://www.cnn.com/2019/12/27/health/us-tobacco-age-21-trnd/index.html

For those of you who don’t already know, the federal “smoking age” was raised to twenty-one years of age in the United States in December. To be able to buy any product containing tobacco (or to legally be able to use it), you need to be twenty-one years of age, which is a deviation from the prior age of eighteen. This is a change that I welcome, although I wish that cigarettes would not be sold at all due to the fact that they are a known carcinogen and contribute greatly to the incidences of lung cancer that we see, particularly in later life. As I’ve said in previous posts, if people insist on wanting to… consume, or imbibe, nicotine, there have to be safer ways to bring it into their bodies than smoking cigarettes given the comparatively astronomically high rates of lung cancer that occur as an almost direct result of years, or even decades, worth of smoking.

Humorously, given my experience with smokers, I have never thought that marijuana has been the “gateway drug”. In individuals who have been susceptible to it, I have thought that cigarettes have been. But I understand the pathophysiology behind addiction better than at least many other people out there, and I’ve seen how addictive nicotine can be and has been in at least three people that I have known in person so far.

Although this might put addicted smokers in a bind who are over the age of eighteen but under the age of twenty-one given that they will no longer legally be allowed to smoke, I see this change in law being nothing but for the best(, as do I look forward to a day when cigarettes are no longer manufactured to begin with).

I never thought I would say this, but…

My asthma is actually somewhat better now than it was several years ago.

Comparatively, that is. For me. I’m aware that my asthma is also worse than other people’s.

Probably many other people’s if you want to get down to brass tacks and be honest about it.

A few years ago, I was at a place where I needed to take prednisone roughly every month and a half without fail… and there were some stints when I needed to take it every three weeks. It was my primary disabling diagnosis. I got short of breath doing simple things around the house, and any real form of exercise was out of the question. Friends of mine used to joke, with my permission, that I would be lucky to make it to forty… except that wasn’t entirely a joke as much as it was all of us honestly hoping that something would not trigger a fatal asthma attack in me before I actually turned forty years old, let alone anytime soon — in, say, the next several months. I had to have conversations with people that knew me in person about what I would want done if I were to be found unconscious as a result of a severe asthma attack, how far they would want medical professionals to go to attempt to save me (did I want to be ventilated? how long did I want to be left on the ventilator?) if the absolute worst were to happen. It was no big deal that I frequently had coughing attacks and coughed up at least a handful of mucus as a result of them and then could breathe better for a time. But sometime between then and now, something gradually changed. Just a bit.

As my migraines progressively got more frequent, and more severe, my asthma dialed it back. Just a bit.

Almost in lockstep.

Exercise still leaves me absolutely winded, and exerting myself too much is still something that I have to pay for in spades if I actually do it, and I still do have to nebulize fairly frequently, but for some reason, I am not quite where I was at a few years ago. I am still not quite sure why that is. With the black humor that I like to use to cope with just about everything, I like to joke around and say that enough people prayed for me not to die of a fatal asthma attack that now, instead, I have severe migraines to deal with. I managed to live long enough to have another problem to deal with. (And maybe that’s actually the truth.) I’m not at an actual place where I have to worry about whether or not I will need to be intubated as a result of an asthma attack.

It’s still really annoying to have to deal with, but we’re not quite there any more.

Readers who have severe asthma, or any severe, disabling diagnosis will understand what I mean here.

I’ve fallen off of the wagon, folks. See?

Monster was this manies when I fell off of the wagon of borderline veganism. This manies, folks!

Prior to my first pregnancy, my diet had… evolved through absolutely no conscious thought of my own to something that was borderline vegan, all through personal taste preferences. Knowing where the various things on my plate had originated from was enough to make me not want to eat some of them, particularly those in the dairy food group. But when I found out that I was pregnant for the first time, I knew that I needed to eat a more diversified diet to meet my body’s increased demand for more calories, minerals, and nutrients, as well as to meet the needs of my growing unborn child’s… and surprisingly, it was not that difficult to find various ways to do so. But after he was born, I never picked my previous diet back up, and by the time that I found out that I was pregnant with Bub, there was no diet to change, as my diet continued to be omnivorous. But when I decided that I was done having children, I began to give modifying my diet back to what it had been prior to either pregnancy some thought. And that’s something that I continue to give some thought to, balancing the need to model eating a diversified diet for my autistic children against eating the things that I want to eat, as I could honestly go without consuming food with cow’s milk in it and eating meat for the rest of my life and not miss either one of those things. The only thing that I think I might miss is eating eggs, but I’ve heard that there are great egg substitutes… so I might be able to enjoyably eat those.

On top of that, being someone who needs steroids for her asthma almost at whim, being able to eat less foods that tend to “go bad” quicker (dairy and meat tend to do this, but especially meat) is appealing to me for that reason as well. These are also foods that tend to cause me the most gastrointestinal upset when I am ping-ponging off of prednisone, especially in combination with other migraine medications I may need.

That said, I suppose that it wouldn’t hurt to begin looking back into various substitutes for things out there…

Prior authorization drills are fun.

And by “fun”, what I really mean to say is “attempts by insurance companies to gatekeep patients away from necessary medications, attempting to justify not wanting to pay to cover them”. What happens is:

· your doctor decides that you need a medication, and prescribes it
· that prescription is given to your pharmacy
· your pharmacy attempts to fill that prescription for you
· this script is presented to your insurance for coverage
· insurance denies coverage of this script
· they request that your doctor fill out forms attesting to your need for it
· your doctor has to fill out forms stating that yes, you need this medication
· these forms are sent to your insurance to approve
· if approved, your insurance authorizes your pharmacy to fill the script
· you are able to pick up your medication from the pharmacy

Basically, it’s a really snarky, underhanded, “but do you really need the medication?”.

A few medications that I take require this, and they require documentation that I have tried to take other medications and that they have not worked on me to be submitted… every twelve months.. for my insurance to continue to approve these prior authorization forms (as though these medications that I have tried in the past will suddenly, miraculously work on me one day) so that I can continue taking necessary medication…

To say “it’s a hassle” might be understatement of the year, and we are only in January. But it’s the truth.

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