Sunday, July 30, 2006

Work and Getting A Free Lunch

The New York Times 7/28/06 posted an article about the drug makers pay for lunch as they do their sales pitch. While the office staff at medical and doctor offices must love the free lunches, the doctors dont like it. Some medical institutions like UPenn and UMich barred industry-paid lunches from reps. Having a lunch budget from $500-2000 is pretty nice! Better yet, my friend who works as rep, says that she's loving the experiences and interactions with the doctors (plus, the work benefits are enormous and pays well.-- but, she did say it is demanding, since she has a quota to see 50 doctors per week!) I wish i got a free lunch. Maybe i should switch careers?

Sunday, July 23, 2006

Eye Problem and Finally Got An Eye Exam

My eyes were giving me problems the last few weeks. They were itchy, red, red when i rub them, and always producing discharges (that gooy stuff, and have made opening my eyes in the morning literally hard.) When my eyes began to be very teary, and almost constant, I decided to see my general PCP doctor. They were able to see me the same day I called, and he said it's bacterial infection, and that it's very contagious. He gave me a prescription for an antibiotic ointment to use for several days, and said that i should see an ophthalmologist to get my eyes thoroughly examined (plus, he seemed very concerned when i answered to him that i saw an optometerist 7 years ago.)
After a few days later, I called an eye doctor. Choosing the eye doctor was difficult. The guy my PCP suggested was a single practice, and my insurance wouldnt cover it. So, I looked at my health insurance's website to see which doctors accept my insurance plan. I decided to go with an eye doctor that has several physicians working in the practice. I also looked for location, education, residency fellowships to get the best doc. (Another source was to ask friends and collegues; but most saw optometrists.) --I wanted to see an ophthalmologist; since I feel more comfortable with someone (a MD) who has had more specialized training (plus general medicine training) than an OD. Both can diagnose vision problems and eye diseases, prescribe eye glasses and contact lenses, and prescribe drugs to treat eye problems. However, if there was a problem that requires surgery, only the MD can do this. Degree wise...OD school is 4 years, and after graduation, they take written and clinical state boards. Then, usually at least a 2 year clinical residency for those wanting to specialize in certain areas of optometry, such as contact lenses, family practice, geriatric, hospital-based, ocular disease, vision therapy. The MD ophthalmologist attend 4 years medical school, complete 1 year internship and 3 years residency, and then they can enroll in specialized training, such as corneal disease, retina/vitreous disease, glaucoma, pediatric eye problems, plastic surgery. Surprisingly, the practice that I chose has 5 MD's, 2 OD's, opthalmic technician, and opticians.

My exam was scheduled in the morning. Ideally, I wanted a late afternoon appointment so that i can leave work early and go home afterwards (especially since most MD's perform dilated eye exams.) Did you know: If you wear glasses or contacts, the eye professionals recommend having your eyes checked at least every 2 years. (if you dont wear glasses or contacts, age between 20-29, you should have eyes checked once; twice between 30-39, and every 2-4 years between 40-65; thereafter, every 1-2 years; And, if there's any family history of eye disease or you notice a problem, they recommend you see eye doctor asap, and regularly.) I have contacts and glasses, and as I mentioned earlier, am very long-overdue for a complete eye exam and prescription check. While I'm okay with my current contacts and glasses, at times I do feel I could use a slight increase in prescription to see things abit clearer. (So, I knew that my prescription probably needs an increase of .25 or .50 in prescription. I just delayed it because I never thought of it as problematic.) Well, my eye exam was very different since my last visit with an optometrist 7 years ago. The whole thing was shorter than what I thought it would be. I arrived a few minutes early than my scheduled time. There was only another patient there; and the office did not have a waiting room. It was open to chairs in the middle, a side room with vision acuity machines; another side room where their optician and eyeglasses store was; and a hallway with few patient rooms. When I was called by the technician, we introduced ourselves and she began by having me sit in front of a machine. "Put your chin in the chin-rest, and your forehead against the support, and keep still and eyes open. Try not to blink." I dont know how many times I was told to do this during that hour. The machine was dark and I didnt know where to look at. "Just look straight into the machine, keeping your head and face still, and dont blink." I tried to do that; mind you, my eyes were somewhat teary and itchy. After a few seconds of seeing darkness and hearing something from the machine, I saw a picture of a long street in a desert with a tiny scarecrow standing in the center, kind of far away, with a background of that looked fuzzy. Within a millisecond or so, it was focused. This was repeated in my left eye. An autorefractor, was used; it provided her with my refraction measurements instantly. She also measured the strengths of my lenses (to my glasses and contacts). Afterwards, she had me sit down in the exam room with the lights dimmed, and gave me the standard Snellen eye chart test with contacts/glasses off. She also had me read a card at arms distance away to test my near vision. To make a better prescription, she used the photopter-- the mask that goes over my face and eyes with tons of lenses, and asked "is 1 better than 2", "is 2 better than 3", and so forth. I hate this part because it's too subjective and I felt that most were about the same or no difference. And this was repeated with the other eye. She wrote down the new lenses and positions, and said that my vision is relatively okay, with just a minor correction in both eyes. That was good to hear. (just like what I thought). Next, she tested my eye movements, my eye's response to light and dark, and their ability to converge on a fixed point. She had me sit in front of another machine, with the chin on the rest and the head on the forehead support, and tested my peripheral vision with the computer. I was told to stare at the center point, which was very easy. Whenever I saw a tiny light flash within my field of view, I pressed a button. It was like playing war games; without moving the eyes. This took a minute. When finished, she had me sit again on the exam chair, and then placed yellow drops into my eyes that made me see kind of yellow glares in the dimmed-light room. She placed about 2 drops into each eye, since my eyes blinked really quick as the drops were dropping from bottle. The blinking-reflex is fascinating; the body doesn't like drops of anything being splashed into the opened eyes. And, you can imagine my head moved slightly to try to avoid the drops. But, she managed to get drops in. I wiped some excess liquid with a tissue and the tissue was orange. She placed the slit-lamp binocularscope towards me and sat in front of me. She shined light individually to my eyes. It was a general exam of the exterior of the eye. As I was told to stare toward a corner of room, my eyes started feeling kind of heavy, full and tired. It was wierd...they were getting numbed! Plus, the light in the dimmed room was very bright. The reason for the numbing of the eyes was to actually to perform the "golden standard" exam in eye medicine: measure pressure of the eye to determine the risk of glaucoma using applanation tonometry

(plus it gives a better of the internal eye structures and getting a "wet" refraction test, to see how my vision acuity is without accomodation. A probe, connected to the slit-lamp, was aligned to my eye by the technician and shined a blue-light. She positioned the probe by also making sure none of my eye lashes get in the way. Once it touched my cornea, it measured the intraoccular pressure (IOP) or the force required to flatten the cornea apex. I only felt the probe touching my eyelashes or the perimeter of my eye. ALso, the tech had to hold my eye open with 1 hand while aligning the probe with the other. So, maybe a slight pressure touch on eye; but, not bad; probably due to numbness of eye. This was repeated with the other eye. This was definitely much better than the non-contact tonometer used on my eyes by optometrist (7yrs ago). The small puff of air that gets blown on my cornea was definitely "felt" by me; and that scary, direct-air wind on eye made it feel dry. Usually after the first eye gets air blown in, I occassionally move my whole head away from the machine for the next eye. It usually takes several attempts by the eye doctor/technician to get the air in my 2nd eye; since I then knew what to expect. Maybe this is why MD's in the office use applanation technique with eyes numbed. Moreover, it is considered more accurate. She said the pressure was normal in both eyes. She also had me sit in front of another machine that takes many measurements of my cornea and provided a detailed colored map of the contour and shape of my cornea, by using a keratometry measurer.Topcon KR-8000PA Auto Refractor/Keratometer/Topographer

They had a corneal topographer, which is used for fitting contact lenses and mapping the curvatures of the cornea for astigmatism, corneal disease, or irregular shapes.

I do remember getting another set of eye drops; eye drops for dilation. She then discussed with me my eyes, and said based on the prior tests, my prescription will only be 50 stronger in each eye and less stronger cylindrical lens. No astigmatism. She said the eye doctor will be with me in about 10 minutes. So, I was sitting in a partially dimmed-lit room waiting for the eye doctor. My eyes felt normal, but the full/heavy feeling of eyes was still around. After the eye doctor came in and we discussed my medical and eye history, she performed slit-lamp eye exam where she examines the interior of my eye in more detail...and took a digital picture of both eyes. All I remembered was that the light was much more intense than when the eye technician was looking at my eyes. (This is because there was ample time for the dilating eye drops to fully open-wide my eyes and made my pupils very large.) The doc said numerous times to try to keep my chin and head in place, and keep the eyes open. I said that the light was too bright and bothering me. She said it's normal; but it's necessary for accurate exam and to see what's causing your eye problems. The doc spent more time looking at my left eye than my right eye. Look to the far right, far left, up, down, corners, straight out. She repeated the same thing with my left eye. (This was my first eye exam where my eyes were numbed and dilated.) I remember that 7 years ago at the optometrist, I had an option to get a dilated exam for "a comprehensive eye exam". I declined because the office charged an extra $30 or $35 and it would not be covered by my health insurance plan at the time. Since my current health insurance plan covered the ophthalmologist's visit as a new patient doctor's visit (referred also from my PCP), I got the full works of a comprehensive eye exam. Another thing I noticed differently this time: this doctor's office takes digital pictures of patients' eyes, and keeps digital records from all of the various exam procedures. The slit-lamp scope had a digital camera. She took a few photos of both eyes. She said the slit-lamp pictures, the interior retinal photos (aka dilated fundus photographs) Topcon TRC-NW200 Non-Mydriatic Retinal Camera, along with the cornea topography, visual field, tonometry assessments, and refraction measurements will become a permanent record of my eye health. She also discussed her findings. Besides a slight adjustment to my corrective lenses, I have bacterial conjuctivitis and dry eyes. She gave me a prescription for a stronger antibacterial ointment to put in the lower eyelids twice a day for several days. In addition, she said i should do warm compressions to the left and right eyes with a cloth, to break up and remove the discharges. (she said try to do it 4x's a day.) Also, i should take some lubricating eye drops, such as TheraTears or Systain, without preservatives, 3x's a day to keep the eye well balanced. Of course, a follow-up visit was required. And, she said always get your eyes checked once every 2 years for good health. I said ok. Then, paid my $20 copay. The receptionist gave me these cheap shades that slide over my glasses. When I went outside, which was bright and sunny! Boy was it really sunny with them off! I went in my car and saw my eyes! I never saw my eyes so dark! Those mydriatic agents (dilation drops) really work on my pupils! When I looked in a mirror, my eyes were very large... the black spot was big, roundy. I followed-up 2 weeks later, and much better condition of eyes. No dilation needed! After a month later, I got new glasses from an online company; all you have to enter is the details from the prescription, selection of glasses and lens, and then pay and wait in the mail. It costed much less than if i went to Lenscrafter, Pearle Express, Walmart, Target, or local optician.product shot

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I love wasting time, especially at work

How often do you browse the internet for news, shopping, IM, check sports or the stock market during work hours? Have you ever spaced out? Ran errands off-premises? Make personal phone calls? Gosh, i'm guilty of these too. According to salary.com, the average worker admits to wasting away 2.09 hours per 8-hour workday, not including lunch and scheduled break-time. The article Wasted time at work costing companies billions describes their recent survey of top time-wasting activities (surfing internet for personal use), excuses for it (dont have enough work to do; followed by underpaid for amount of work), HR assumes 0.94hrs wasted/ suspected by HR is 1.6hrs; the older you are, the less you waste time; industries of insurance, public sector, R&D, education and software/internet companies waste the most of work time; the time-conserving industries were shipping and receiving, manufacturing, healthcare, finance/banking/marketing communications. The only thing is that most people I know work more than the "normal" 8 hour day (9-to5).

My introduction and welcome

Hello everyone. I finally did it! My first blog. It really feels like i'm just talking/typing to the wall and no one is going to read this or care what i have to say. I'm okay with that. Either case, the main purpose of this blog is to save everything. Yes, savingeverything. SavingEverything is the theme of this blog. I will save everything here that effects me in some way in the real world. I envision this as my open, personal, anonymous journal, and also an open wallet with some thoughts along the way. If I see something that I like online and have an interest, I'll blog it. If I experienced something and want to share it with you, I'll blog it. (Even though it may not apply to you, there is someone who is reading this blog that cares. In addition, remember, this blog is about me, SavingEverything.) Several topics that I may include blog posts are: saving money, making money, ways to get more for the dollar, the housing market, my decision-making process, interest rates, shopping, news, mp3's, stamps, books, beer and wine, vacations, trips, adventures, and pretty much anything. The best part of blogging, as I see it, is a way to enlighten others and also have open communications between you and me through the comments so that I can be enlightened by you. SavingEverything here will allow me to share my experiences and things that I came across, and hopefully, will benefit you the readers. So here begins my new journey into saving everything!

One topic that I am more inclined to discuss is money. Saving money is easy to say than do. I will admit that I try to save when and if I can. When working, I automatically save some money by having a % of my paycheck go directly into my 401k retirement. However, even with 401k savings, it's important to try to save some extra money from your net salary, for either emergencies, big purchases, or just for long-term savings. I live paycheck by paycheck. I think we all live paycheck by paycheck. Without the paycheck, how will you pay for your living costs? Most people probably spend about 67-90% of their gross salary [includes FICA/est fed-state-local taxes/est company health-dental insurance/living costs/utilities (regular cable $50, cell phone, landline, electric, gas, oil, water)/gym]. Note: does not include any deductions for 401k or other plans; and it's my crude estimate. The median is around 75-80%. If you earn more and are careful with your spendings, you would spend around 50-67%. If you earn less and live singly, you spend alot and cannot save as much. If you live with a roommate, you definitely save a few hundred, and it brings your spending down with shared utilities expenses. Either way, living on your own is not easy and way different than college years. I remember when rent in my college years was $310(x2) in a 2-br apartment, plus utilities. During that time, rents in the big cities were still big....at least 4x's it. Well, now, i dont know the rents in my college town. I'd guess it's almost double. But, where i live now, rent is high....and at times, i feel like i'm throwing money away (vs. buying a condo). Other times, i think buying is similarly throwing money away to banks and throwing away savings. I just dont know; buying would definitely make me save more, but the actual dollar amount would be less than renting. Oh well... that's 1 thing that i'm unsure what to do. Then, other times, i think my investments are just bad and also just like throwing money out the window. I have a high risk tolerance, i guess. But, for some reason, if i buy a house, i feel that's a higher risk... especially since it's linked to income. And, who knows, i dont know what's going to happen 2-3 years from now. I may be working somewhere else in a different state. Or, i may be working at the same place. It's the uncertainty, and buying property (to me, more riskier because if I would ever run a problem with income and unable to pay mortgage, i'm in more trouble... plus the fact that the loan is much bigger compared to say, a margin loan in a brokerage account.) OK. Enough for now. I rent, and will continue renting and saving along the way.

A little about me... i'm in my late 20's approaching 30 shortly, single, in northeast, currently work not in the business or computers field, educated, not well-paid, but am happy with work and life. (if i were to buy a property, it would be this new development i've been eyeballing, that is ~1000 sqft, $230-249k (as of july06), plus taxes, condo fees, and a few miles further away from work,. but, that price would make me live very tightly with money, and I'm not sure I would be able to really saveeverything.)

Disclaimer: The information provided in this blog is for entertainment purposes only and does not provide any medical, legal, financial, or other professional or non-professional advice. You are reading and using any of the information from this blog at your own will and risk. This blog is in constant transition; therefore the content could be invalid and inaccurate.