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5/31/2020

5 Day Water Fast

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I haven't been doing super awesome in this quarantine when it comes to my health and fitness goals. To try to get back on track with my goals I decided to embark on another fast, this time extending it to five days. Similar to my last fast, which was three days, I chose to continue to include some diet sodas and water enhancers but the majority of my intake was water. I made sure to add in electrolytes so that I wouldn't have muscle cramps and other side effects as well as limited my exercise significantly and added in some extra sleep each night. 

My results were actually really good on the weight loss front but I wouldn't recommend this as a purely weight loss tactic as it can be quite difficult and has a potential to cause issues with your mental view on food if you have issues in that realm. So, results:

I lost 10.3 pounds (but I gained 2 pounds back over the next two days so I would say just over 8 pounds in 5 days).

As for measurements, see below for the amounts I lost during the five days. 
Chest: -1.5 inches
Bust: -1.2 inches
Thigh: -2.0 inches
Hips: -0.5 inches
Belly Button: -1.5 inches
Waist: -1.5 inches
Arm: 0.00 inches
Neck: -0.3 inches
Calf: -1.0 inches

Total Inches: -9.5 inches

All in all, I would say it was a good experience but there were definite down sides. For instance, my energy levels were noticeably lower during the week. Watch the above video on my channel (subscribe for new content 3-5 times per week!) about the results and experience.

​Until next time,
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9/13/2019

I Did a Thing… 72 Hour Fast & Results

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Fasting is not a new thing in general and it’s not a new thing for me personally either. I’ve fasted for surgery, for blood work, and I’ve done intermittent fasting on and off for the past year. I’ve never been a breakfast person so it wasn’t a difficult switch for me to do once I got into ketosis. This time was a little different though as I went for three full days. The longest I had ever gone in the past was 24 hours or so.
 
I hadn’t intended to fast for 72 hours when I woke up on Friday morning but nothing seemed good to me, and I certainly wasn’t interested in my packed lunch. In the past I would have likely just thought about what could fit my macros and then gone out and purchased something but as I am trying to save money I decided to just wait until I got home to eat. After all, I wasn’t hungry and I had food in my lunchbox if that changed. Once I got home I got busy with odds and ends… cleaning the house, teaching classes, writing up student feedback and etc. and completely forgot to eat. When I realized I’d gone well over 36 hours the next afternoon I figured I may as well push it and see if I could do a 72 hour fast. I had heard of really good results when it came to autophagy and general wellness for a 72 hour fast and I still wasn’t particularly hungry so figured now was the time to try it.
 
Most of the time during this fast I wasn’t hungry. There were the occasional urges to eat but they were from boredom or that it was the right time with two exceptions so were easy to ignore and go about my day. The first exception was when I was teaching a class all about food. Talking about food and being hungry for 25 minutes made me think hard about going and making something to eat in my kitchen but, as it was the first of 5 classes that night, I was back to being not hungry by the time I was finished teaching for the night and just went to bed without dinner. The second exception was right at the tail end of the fast. I had been cooking hamburgers for meal prep so the house had smelled like burgers for hours and, I’ll admit, I started watching that timer count down to 72 hours during that last hour or so.
 
The experience was actually really good overall. I felt very relaxed all weekend, got in a simple workout routine, cleaned my house and slept really well. I will definitely try to incorporate at least one of these per quarter if not more often as I hope to see some results with tightening skin (from the autophagy) as I continue to lose weight. I would not suggest going from a carb heavy diet directly into a fast though, it would likely be miserable, at least from my experiences with intermittent fasting and OMAD I can imagine that I would not have made it to the end.
 
Results of the fast? I started Thursday at 231.4 and ended Sunday at 226.4. That’s a five pound loss, which is amazing. Not all of that stayed gone after eating my first meal, as expected. The next day I weighed in two pounds heavier and the day after one pound down from that weight. So I would say that it leveled out at four pounds lost for the fast after taking into account that first day’s fluctuation. From the autophagy side of things I didn’t notice much of a difference but hope to as I have more loose skin to get rid of. Fingers crossed!
 
Until next time,
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5/26/2019

14 Ways to Save Money on Medications

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Medical costs are on the rise and, if you're anything like me, can add up in no time at all. I know that I'm not the average patient when it comes to my annual medical spend (I hit the max every year... thank you chronic illness) but even low utilizers can find themselves paying more than they should for medical care. I wanted to take a few minutes today to pass along a few ways to make sure you are getting the best deal on your medications- the bulk of most people's annual medical cost.

If you haven't yet read my post about questions to ask before choosing a medical plan please click over as the number one way to save money on medications is simply to understand your medical and prescription drug plan. 
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1. FSA and HSA Plans

Flexible Spending Plans (FSA) and Health Savings Plans (HSA) are accounts you are able to put money into on a per paycheck basis for medical bills on a pre-tax basis. If you have these plans available to you a strongly suggest that you explore those plans and run the numbers in various scenarios as they can save you a lot of money each year. In the case of HSAs they can also let you invest for future health care costs in retirement as well plus both of these plans lower your taxable income which is a plus.

2. Try a Sample First

When you are prescribed a new medication you are typically given a script for a month's supply. Sometimes that new medication simply doesn't work out due to negative side effects or incorrect dosage and the rest of the prescription is wasted as you can no longer take it and have to get a new prescription. This waste- or resources and money- can be stopped by asking for a sample from your doctor before filling th prescription. They can often give you a week or even a month of medication for free to try before you buy as it were. If it works for you- awesome, less money out of pocket for something you love. If not- at least you didn't spend money on something you won't use.

3. Check Your Insurance Program's App

The insurance program's app is often under utilized. Heading to the app can give you an e-card if you don't have a physical card with you can be helpful but they often have price comparison guides, lists of covered medications, contact buttons, and more just a click away so that you can check before you even leave the doctor's office what your costs are going to come out to (estimated of course). 

4. Switch to Generics

Generic medications are not the exact same formulation as the name brand but they are very similar and depending on your other medications, treatment needs, allergies, and etc. you could very easily be taking a generic form of a medication and see no difference whatsoever- other than big savings. There are circumstances where people are not able to tolerate one generic form of a medication or must take a specific brand name medication and those circumstance would out weigh the financial situation but the chances are that you can, and should switch to generics whenever possible.

Example (according to GoodRx): EpiPen
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5. Ask About OTC Options

If you are on a pricey drug and have seen medications on the shelf at Wal-Mart that claim to treat the same ailment your prescription is treating you might need to switch to that over the counter (OTC) medication. Check with your doctor before making any medication switches as there may be other ingredients or drug interactions that are at play. I am currently on 3 OTC medications that the doctor has included in my daily treatment plan. This does mean that those costs -are not included in my deductible or out-of-pocket max though so I personally pay more per year due to this but I hit that max every year with my medical conditions... for the average consumer this will be more likely to help their budget than hurt it. Run the numbers to find out though and you may even be able to do this in reverse if there is a covered prescription drug rather than the OTC version. 

6. Check Your Dosage Options

Just because the medication is double the strength doesn't mean that it is double the cost. Ask your doctor if the medication you are taking two times a day is available in a scored tablet for twice the dosage. If it is you may be able to split the pills yourself each day and save money. Its important to ask if your medication can be split or not as extended release medications, caplets and some other medications cannot be split safely.

7. Price Compare

You may think that the price of your medication will be the same no matter where you pick it up due to your insurance card but that's not actually true sadly. Your insurance provider negotiates the prices of medications with these distributors so the cost varies by where you get your medications. There are apps out there whose sole purpose is to show you the cost of your medications at various pharmacies so that you can make an informed decision on where you fill your medication prescriptions. Combined with your insurance and any coupons you may have or be able to get through any of the options below you could save a lot of money and even get some medications for free!

On this note... you should also ask how much it costs in cash, without insurance when getting medications. Sometimes it can be cheaper without insurance or you can use a coupon you couldn't with insurance to get a better deal. Be aware that going outside your insurance company means that it doesn't count towards the deductibles and out-of-pocket maxes so it may not actually be a better deal long term but depending on your situation it could save you money to go this route.

8. Mail Order/Bulk Delivery

Often times you can get a discount on the medications you take every month by having your doctor write you a script for 90 days rather than 30 days. You can have this 90 day prescription filled by an online pharmacy and shipped directly to your house saving you money on gas as well as the cheaper-per-dose prices for ordering in bulk. I typically use the one my insurance recommends but there are cheaper alternatives sometimes... just be very careful if you do this to verify the legitimacy and legality of having that particular pharmacy ship you your medications.

9. Coupons & Patient Assistant Programs

Bet you didn't know you could coupon medications. You totally can! Not every medication has a coupon or program available but a quick Google search of "Medication + Coupon" or "Medication + Patient Assistance" could net you big savings. I personally am enrolled in a program that pays most of my costs for a medication that costs over $2,000 per month up to $10,000 per year as well as using a coupon for my annual Epi-Pen (generic brand, of course). I have also had coupons for free inhalers and other medications. Many of these coupons and programs have requirements and stipulations (such as being under a certain income, having or not having a certain type of insurance or etc.) and an approval processes but taking the extra time to fill out the forms could save you hundreds or even thousands of dollars each year. The coupons might get you a discounted rate on the medication, a rebate for your medications if you mail in the receipt, or even free medication for a limited time. Most of these are from manufacturers so you do have to get the exact brand which isn't always the easiest to do but its worth it. My pharmacy is special ordering the generic Epi-Pen that I have a coupon for so that I can get the lowest possible price for my necessary medications, it will take a few extra days or maybe even a week but I'm willing to wait as those savings add up.

10. Prescription Savings Cards

This one is one that I will tell you to be careful with. While you can save money at point-of-sale for your medications potentially you may be going around your insurance plan to do so. Doing this means that it isn't being counted in your deductible and out-of-pocket amounts so, like moving to OTC medications, it may actually cost you more in the end if you are going to be getting up towards that out-of-pocket maximum amount by the end of the year so run the numbers and make sure you're making the best decision before you do this. Some cards don't go outside the insurance and work the same as a coupon though... just be careful and ask the Pharmacist to explain all your options and how it will interact with your insurance plan before choosing this option.

11. Pharmacy Discount Plans

Pharmacies are always trying to get customers in the door and need repeat business just like any other business so they often will have discount programs for their customers that they run... especially big-box stores like Kroger and Wal-Mart. Wal-Mart has a $4 prescription plan for instance for a 30 day supply of medications for a list 2 pages long. If you are taking one of these medications then it would be a good choice to consider them for filling it. They make money off the other medications you fill with them as a repeat customer so it makes sense for them and it makes sense for you as its cheaper. One thing to note here is that if you are getting medications at different pharmacies you should make sure that they all know all medications you are taking. If they don't they can't give you important information about drug interactions or valuable suggestions on alternative options. They may even be able to match price with the pharmacy you are getting your other medication from if you let them know that's why you aren't getting all of your medications from them.

12. State Subsidies and Other Care Plans

Depending on your situation you may qualify for additional assistance from the federal or state government. If you think this could apply to you it is important you reach out to to their assistance agencies to find out if you qualify. These programs are often limited to those in lower income brackets, on other assistance programs, enrolled in Medicare or etc. but looking at all of your options is an important part of advocating for the best possible care you can get.

13. Talk to Your Doctor...

If you have a question about why you are being given a specific medication or if there are alternative options then the best person to ask is your doctor. Being open with them and discussing the financial implications of your treatment plan is the first step towards being an informed, involved participant in your own care which is what we all should strive to become. If you let your doctor know that X medication is higher priced than you can afford and ask for alternatives they can help. Often they are not aware of medication costs as they are not involved in the negotiations your insurance company has annually with drug manufacturing companies, but once they are aware they can help you find an alternative treatment option that is a better fit financially but also works for your health management.

14. Ask Your Pharmacist...

The last tip today is simple to ask the pharmacist: is this the cheapest option? They may know of a coupon or other discount that can save you money on the spot. 

Don't...

  • Skip doses or under medicate to save money. You can end up with more serious health repercussions that not only would cost you more money in the long run but could also risk your life.
  • Buy medications from someone other than a licensed pharmacist.
  • Forget to verify the legitimacy of an online retailer/pharmacy before purchasing medications.

I've been wading through this costly medical system most of my life but hopefully you won't have to waste as much money as I'm positive I did over the years while still learning about these options with these tips.

​Until next time,
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5/19/2019

Questions to Ask Before Choosing a Medical Plan

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Formulary, Preferred, Generic, Name Brand, Off Label, Pre-approval, Copay, HDHP, PPO, HMO... there are so many possibly unfamiliar terms when it comes to medical insurance. When you are signing up for a medical plan, whether through your employer or the market place, it is imperative that you make yourself an informed consumer. This means taking the time to understand all the ins and outs of the plans available to you and your family. If you are choosing insurance through your employer the Human Resources department can be an invaluable resource for you. They know the ins and outs of your plan(s) and if they don't have an answer to a specific question they can often give you the number of someone who will. It is important to remember that they are still your employer and coworkers so you may not want to share ALL your medical information with them but they can help to explain your plan options in broad strokes so that you can chose the best plan for your family. A few things to look for:

​What pharmacies and providers are in-network? 

Never ask a provider if they 'take' or 'accept' your insurance- the answer will likely be yes- you want to know if they are in-network. I'm not completely jaded and understand and even trust that most providers will be up front with me if I mess up and ask if they take my insurance but I was burned once, badly, and learned my lesson so no longer do this. In my case I was lied to by a front office staff member at an Urgent Care center and spent the better part of a year fighting about those out-of-network costs with the provider and my insurance company, it was not fun. If there is a provider that it is important that you see then you should call the insurance company and ask if they are in-network before you sign up for a plan and double check with your insurance company before going to a new provider. ​​Going out of network can mean significantly higher costs not just for your specific medication or visit but for the whole year as you have separate in- and out-of-network deductibles and out-of-pocket maximums. It may look something like this:
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​Are there Preferred pharmacies?

This can often save you money as well. You will often see this affecting you when it comes to co-pays and co-insurance so it never hurts to ask. Going across the street could save you 10%!

​What is my deductible?

​Is there a per person deductible or per family? Does it include prescription medications or is that a separate deductible? Some plans will have a separate prescription deductible that you will have to meet before medications reduce in price or become paid for. This deductible will typically go towards to you out-of-pocket maximum just like your medical deductible but its important to know if you are going to be juggling multiple deductibles.

​What is my individual and family out-of-pocket maximum? 

​If you have one high utilizing family member then its important to note that often plans will include a per-person cap that can keep your costs lower... you many not have to get all the way to the family out of pocket max to stop paying for that person's care for the year. This can be a lifesaver when it comes to the budget.

​What medication are formulary or covered? 

Check the plan every year, even if your plan has not changed, to make sure that all your current medications are covered. Insurance companies issue a new list of changes each year and you can often find this on the website but if not then simply call in and request it.

​How does the co-insurance work?

​Once you hit your deductible you will often still be responsible for some of the costs until you reach a higher number, the out-of-pocket maximum. This is usually calculated at a percentage. So if you have a co-insurance of 80% once you hit your deductible that would mean that you are responsible for paying 20% of the cost for your care until you reach that number. In and Out of Network still apply for this portion of your yearly cost so its important to stay in-network if at all possible.

What are the requirements for Specialty medications?

For certain medications, typically higher costing medications and ones that require temperature control, some plans will require you to use their Specialty Pharmacy in order to get them filled. This saves them money which in turn saves you money in the long run but it can be a little frustrating to have to schedule delivery for these medications and call in your payment/authorization to ship each month. If you have a medication that falls under this type of requirement they will let you know when you try to fill it at a retail pharmacy but if you think it may apply to your situation it could speed up the process to simply call the insurance company to ask up front what their policy is in regards to that medication. Processing at these pharmacies takes much longer than your corner CVS so planning your doses out is imperative for these kinds of medications.

How do Prior Authorizations work on this plan? 

Certain medications, treatment plans, surgeries or even provider types may require Prior Authorization in order to be covered. These will typically span a length of time and then require renewal if it is an ongoing treatment. This is a pain to go through and number two cause for my personal medical plan headaches but its important to understand and follow this process or you could end up paying the full cost of treatment as the charges will be denied.

I am personally on a medication that costs over $2,000 per month for me to take... you can bet it requires Prior Authorization. Every 6-18 months (depending on how long they authorize the treatment plan) my doctor's office has to file paperwork showing that I still need the care. Sometimes its easy but other times its a fight. Sometimes its just not worth that fight and we will chose an alternative treatment or I will pay out-of-pocket, like i did for my current rescue inhaler. Being prepared for this process and not letting it frustrate you if important- the insurance company is trying to keep their costs down by verifying that the treatment is necessary which helps keep costs from rising even more for everyone.

What do I need to do in order to see a Specialist?

For some types of plans all you have to do is show up to receive covered care but for other you may need a referral. Knowing this up front will save you headaches and money from fees for seeking care without a referral. 

Is ____ covered?

If you are looking for a specific type of care then ask up front if it is available on plan and if so how many sessions/how often you are able to get it. A good example of this is chiropractic care. Some plans offer it but they may limit the number of sessions you are able to have covered per year. Other options could be infertility treatments or in-home care. If its not then you may need to purchase supplemental insurance or go with a different plan.

​Are there any perks to the program? 

I am with Blue Cross Blue Shield of Texas currently and there are a ton! My plan includes an identify theft program, a gym membership discount plan, teledoc services, free coupons to all kinds of health related retailers, discounted magazines, a wellness points plan and even discounts on services they don't cover like acupuncture and massage at certain providers through one of their free programs. On the wellness plan I get points for doing things like going to the gym, taking an online class, entering my stats quarterly, and etc. which I can exchange for prizes like kitchen gadgets, gift cards, and more. You can bet I participate in this when I have time... a few minutes while waiting around gets me a little closer to a free blender. :)

Does this plan qualify for a FSA or HSA? If so is one offered?

Flexible Spending Plans (FSA) and Health Savings Plans (HSA) are two ways that you can pay for medical costs with pre-tax money. They both have their own requirements as well as good/bad points but having access to pre-tax money can save you quite a bit of money. I'll do a separate post on these plans but if your employer offers them please learn about them and utilize them. They may also have a Limited FSA just for Dental and Vision, a Dependent Care FSA to help pay for childcare expenses pre-tax or an Health Reimbursement Program (HRA) that, while it isn't tax free, is free money to help you meet your medical costs if you submit for it. All of these plans are going to be employer specific in whether they are provided and through which providers but making sure to really understand your benefits package is an important part of providing health care for your family and being an advocate for your own.

I hope this helps you navigate your medical insurance journey.

Until next time,
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5/12/2019

What I Spend For Medical Care In A Year

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It’s difficult to explain how important it is to lower my monthly expenses by paying off my student loans- as well as other debt- without explaining where a huge chunk of my annual income goes without any real choices… my medical expenses.

​For someone like me who has chronic illnesses, maintaining health insurance coverage can literally be the difference between a fairly normal life and absolute destruction. I make the joke that I work for health insurance but to be honest it’s not much of a joke. According to BCBSTX the billed amount for my medical expenses in 2018, a really good year for me with only one chronic illness really causing problems rather than all three, was $46,823. That’s a full time salary for many in the US and it doesn’t even take into account costs that I incur outside of the insurance plan for uncovered medications and services. In order for me to ever be fully financially independent I need to eliminate as many of my monthly debt payments as possible while also building a large emergency savings so that in the event of a job loss I could afford to maintain my healthcare costs without going bankrupt.

For this reason, I thought taking you through a summary of my anticipated costs for 2019 would be helpful. So here we go. First, some important terms then a summary of this year’s insurance plan and then a quick run through of additional costs.
This post is part of a series that will look at ways to save money on medication, questions to ask your HR representative during Open Enrollment season so that you can make an informed decision and more. Insurance and healthcare are, understandably, a huge passion of mine which I have only dug deeper into since beginning to work in Human Resources four years ago. I hope that this series can be beneficial to you.
 
Important Terms
  • Premiums: This is the amount you pay in order to be covered by insurance. Typically this number is expressed either as a per month or annual cost.
  • Deductible: This is the amount that you have to pay for your care (of covered services, some services are not covered depending on the plan you are under) before the insurance company will pick up any of the cost. This does not mean you are not gaining benefit from having insurance though. If you are ‘in network’ you are only going to pay for the negotiated prices of services which can be a significant cost savings.
  • Out-of-Pocket Maximum: This is the highest amount you will pay for covered services in a given period, typically a year.
  • Co-Pay: This amount is a set fee for certain services such as a doctor’s visit or a prescription. You will typically not see these on the type of plan I am on- High Deductible Health Plans- but if they are on your plan you will likely see them as a set of tiered costs, some for prescriptions and others for types of doctor’s visits.
  • Co-Insurance: This is the percentage of bills you are required to pay while you are in that gap between the deductible and out-of-pocket maximum.
 
My Insurance Plan
I currently have a fairly good plan but it is a High Deductible Health Plan which can get very costly if not budgeted for and fully understood. Being an informed consumer is of utmost importance with this kind of plan as 100% of the cost for services is on you from day 1 until you meet the deductible. Here are the details for my exact plan:
  • Premiums: $544.26 per month, of which I pay $61 and my employer pays the difference. Annually this amounts to $732 which is low. It is a High Deductible Health Plan though so most of the cost comes in from the other costs throughout the year as a rule.
  • Deductible: $2800 annually, this means that I pay all costs 100% until I have paid $2800. For me this is typically February. This year it is March due to a medication being filled on 12/31/18 rather than actually in January so I didn’t have to pay costs usually on my budget for January which was lovely.
  • Out-of-Pocket Maximum: This one is $5400 annually… for an individual plan. Like I mentioned earlier, most of the costs for a HDHP tend to come in areas not related to premiums.
  • Co-Pay: I have no co-pays on my plan. I either pay 100% or my co-insurance rate depending on how much I paid already in the year.
  • Co-Insurance: My co-insurance is an 80/20 split so I will pay 20% of costs after I meet my deductible until I hit the out-of-pocket maximum after which I will pay $0 for care (so long as it is covered).

My insurance plan does not cover two of my currently prescribed medications (up from one in 2017) or any of the over-the-counter medications that my doctor utilizes as part of my treatment plan. This part is standard though, no prescription drug plan will cover OTC medications as a rule and have exclusions for covered prescription medications. Since this particular medication is purchased at a compounding pharmacy is was pretty much known up front to be an uncovered expense. 

It also doesn’t cover some of the testing I have to do at my allergist/immunologist’s office when I am in a flare, vitamins and minerals that I supplement with when symptomatic, or any of the alternative treatments that I have found helpful to maintaining my health. While it is true that most of these costs boil down to personal choices that I have made to seek these treatments the quality of my life has increased drastically since introducing them so keeping them in my treatment plan if possible is ideal.
 
Not Covered Costs Breakdown
  • OTC Allergy Medications: $326 per year, approximately (at current prescribed dosages)
  • Inhaler: $55/each so, hopefully, $110/year
  • Mast Cell Stabilizers: $468/year at current rates which have historically changed mid-year to account for increased shipping costs
  • Tests and Treatments Not Covered: Varies. If it’s a breathing test at my allergist is may run $25 but if it’s extra sessions at the chiropractor’s office or a more expensive blood test that my insurance doesn’t cover it may be a few hundred or even thousands of dollars.
  • If it’s outside of traditional medicine altogether it can get pretty pricey as well. For instance, I’ve been trying IV Hydration Therapy in seasons of high symptoms with really good success but that’s not covered at all and runs $75 to $150 per session in office. Its helped ward off migraines that would have cost me significantly more than that (as well as a lot of pain) as well as helped my boost low blood pressure related symptoms at times but for now it’s not something I can afford to use regularly.
  • When it comes to alternative pain treatments the costs are similar to the last bit… all out of pocket and all things that I wish I could use more as they help my pain drastically but don’t fit in the budget regularly. The first one is massage. Massages and reflexology paired with chiropractic care has helped my pain levels significantly but the cost of a massage can be anywhere from $50-100 per hour in my area depending on type of massage and facility. I’ve been using reflexology more often recently as they costs are more reasonable. Other things that go in this category are OTC medications, TENS units (and the pads, batteries, etc. required for use), essential oils and etc.

Without any of the ‘not covered treatments’ category we’re looking at:
  • Premiums + Out of Pocket Maximum + OTC Antihistamines + Inhaler + Mast Cell Stabilizer... $732 + $5400 + $326 + $110 +468= $7036
  • If I include in a minimal amount of additional treatments I can easily get another $1-2k added to that
  • I do utilize coupons and programs from manufacturers to save money so I will likely save $2-3k this year (it’s impossible to guarantee or know exactly how much due to the exact programs/coupons I will be using)
  • So final expenses for the year, baring any emergency out-of-network expenses, will be between $6000 and $8000 more than likely.
 
Other Costs
One thing that isn’t accounted for in any of these numbers is the fact that I have to be careful about the foods that I eat and products that I use. I am allergic to a lot of things- most artificial scents, gluten, celery (random I know), bananas, and a slew of other things. This translates to needing to use more expensive personal hygiene and cleaning products in many cases as well as having a more heavily padded food budget than your average single person. I wish I could discount this but its part of my life and relates directly to my health issues so it likely should be mentioned. In my house you will find no scented candles, plug-ins, or etc. as they trigger migraines for instance and just this past Christmas I borrowed some basic laundry detergent while on vacation and was covered in hives for three days… so you can imagine a lot of shampoos, detergents and etc. can ruin my week pretty easily.
 
Ways I Lower My Costs
  • Coupons on medications (yes they exist, I’m doing a post on them soon!)
  • Copay/Deductible Assistance Program for my most expensive medication ($2,100-$2,600/month without assistance)
  • Samples of medications and products before purchasing full size products to avoid unusable purchases
  • Putting the maximum into HSA or FSA plans when they are available.
  • Alternative medical treatments (pain medications are expensive, can be dangerous in high dosages and can lose effectiveness with long term use… and the last migraine that I wasn’t able to stop cost me $3k by the end of it due to needing someone to pick me up and drive me to the hospital to get stronger medication)
  • Buying off brand and in bulk- medications and household products both. If something costs 20% more than normal in order to get something that doesn’t break me out or give me a migraine but I can buy in bulk and save 10% then its not really 20% more expensive. The same goes with medications. The costs of my OTC and other non-covered medications are all off-brand and bulk quantities as monthly 30 day supplies would be almost double in some cases.
 
I write all this out not to convince you to feel sorry for me or what have you, because I think that I am extremely lucky to be able to work at all as I have many friends who are not able to do so. And not only that but I have a job I love, that pays me enough to afford the life I have- including insurance and salary that can encompass these expenses, a life that’s amazing with hobbies that bring me joy and friends that bring light and happiness to it, and a family that is just without words wonderful. It’s more than I deserve and I will always be grateful for it all. I write this to show you a window into my life for better understanding of one of my largest “why’s” when it comes to becoming financially independent and debt free. Having a “why” for your goals is important as without one you will be more likely to convince yourself out of the hard but necessary tasks along the way towards reaching your goal.
 
Until next time,
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3/20/2019

Keto Update 4

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It's been two weeks since my last Keto/weight loss update so it's time for an update. I hid the columns from 1/1/18 to 2/17/19 on my spreadsheet as it was becoming impossible to read (yes there is more than a 1 lb loss between 260 and 234 haha) and I wanted to make it easy to see this week's changes as well as totals. Here we go...
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5.6 pounds guys... in two weeks I lost 5.6 pounds! That's awesome news and I'm absolutely thrilled. Even better I went down almost a full point on the BMI scale AND lost inches. I did go up in my chest measurement but I think that I just mis-measured last time as it was exactly what it was the previous measurement day again. That means I've now lost 31.6 pounds and 21.2 inches total. I would really like to get to 50 pounds down by Gaufest in June but I'm trying to not to set unreachable goals (that would be at least 2 pounds per week every single week until then which is not guaranteed even if you are eating perfectly, on any diet plan). Instead my goal is to continue my progress towards 50 pounds gone by the end of the summer and if I get close before then I will adjust the goal to a larger number (such as "below 200 by the end of summer"... for the first time in a decade. That would be beyond wonderful to get there.)

For the last two weeks:
  • Favorite Food: Sliced English Cucumber and Homemade Ranch Dip
    • I'm a texture girl and have been missing 'crunchy' foods quite a bit. I haven't found a good keto 'chip' out there (though I did make some cheddar crisps last week which were a good crunchy snack food) for dipping but cucumber and zucchini do a great job and are cheap. For those about to suggest celery, unfortunately I cannot have it. Instant migraine. Random, I know.
  • Cravings: Peanut Butter M&M's
    • Those things were showing up everywhere and are my, hands down, favorite candy of all time. To combat this I bought some super dark chocolate chips (meant for baking) and a jar of peanut butter. One tablespoon of peanut butter and a few chocolate chips to assuage that craving for sweets and specifically the chocolate & peanut butter combo without completely blowing my day out of the water. Was it the 100% best thing for me to eat? Probably not... but it fit my macros and kept me from falling back off the wagon on stressful days so I'll take it. 

Another thing that I'm tracking is how well my weight loss correlates with what's going on in my life as those might be useful once I have more information. If I lose a lot less weight when I feel my sleep has been horrible than when its been ok or great then I will know that I need to focus more on that for instance. On a scale of 1-10 with 1 being the lowest and 10 being the highest...
Compliance/Remaining "Keto": 9
Energy: 6
Sleep: 5
Stress: 6
Cravings: 2 ​​
Quick Keto Meal Idea:
For lunches this past set of meal preps I've done a number of lettuce wraps: salsa chicken, beef taco, tuna salad, ham and cheese, etc. It's a quick and simple way to eat something you would normally have with a lot of carbs- like tacos or sandwiches- or to mix up the same ingredients in a new way. A few pieces of leaf lettuce and leftovers packs a lunchbox in minutes which is definitely something I can get behind. 
Try some of the following...
  • tacos
  • salsa chicken
  • fajita
  • tuna, chicken, egg or crab salad
  • lunch meats and cheeses
  • leftover Chinese take out (meat and veggie dishes, avoiding starchy items)

What other fillings for lettuce wraps do you do in your household? Let me know!

​Until next time,
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2/27/2019

Keto Update 3

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So I fell off the face of the Earth on this series for a little while and yes it was because I 'fell off the Keto wagon' but I'm back. If you're reading consistently on the blog you will have likely read the "Comfort Eating" post a few weeks ago and I was just not able to consistently keep myself on track for a while after than, on any plan, not just Keto. Life got a little stressful but I've been working on finding ways to manage my stress more efficiently and am hopeful that my stress level won't be an excuse to ignore my health goals in the coming months. Not hopeful, determined. That is a much better mindset I think. I am determined that I will remain on track towards reaching my goals despite stressful situations that might arise. I've been back low carb for two weeks and Keto for a little over a week and have lost the weight I put back on -at the highest was 7 pounds- as well as 1 additional pound. I also lost an additional 0.4 inches off my chest (I had gained 1 inch as of last week but lost it plus 0.4 inches this week) and 0.2 inches off my waist somehow, not that I'm complaining!. 
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My favorite food the last two weeks while I've been getting back on track has been my keto pancakes that I'm sure anyone who follows me on Instagram has seen posted several times lately. They're so good and I'll likely end up doing breakfast for dinner with a few of them paired with scrambled cheesy eggs. A quick meal as I keep a stock of pre-made pancakes in my freezer as part of the meal prep process but still super tasty and filling.

I haven't had that many cravings this week but I did want a couple of carb-y things earlier in the week when I made the transition to keto from low carb. I wanted tomato soup and a (gluten free) grilled cheese when it was cold and wet outside and I wasn't feeling all that great. I expect that one was more of a comforting memory trying to come back into my life- habits are hard to break! The second was ice cream, because ice cream haha. I'm not sure why this one came about but it coincided with some insomnia so that may be related. 

I'm thinking that keeping track of how well my weight loss correlates with what's going on in my life might be useful so I'm adding a scaled list of items that may affect or be affected by my diet. On a scale of 1-10 with 1 being the lowest and 10 being the highest...
Compliance/Remaining "Keto": 9
Energy: 7
Sleep: 6
Stress: 4
Cravings: 3 ​
Next update I may add a few sample days of menus as well but I'm not sure what would be the most helpful. Let me know please. Are you guys interested in meal plans or meal prep posts and videos?

​Until next time,
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1/6/2019

Adding a Goal

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 Part of taking care of my health is making sure to take time to de-stress, refresh and do all the small tasks required for me to feel my best. Thinking on that this evening while meal prepping caused me to decide to add another goal to my “Health & Wellness” section. It’s simple: “Make, and take, time for your health.”

This will encompass lifestyle things I have been meaning to do or have neglected to do in the past. Some of those things:

1. Use a mask at least once a week for relaxation and better skin.
2. Use moisturizer daily to help with skin elasticity and wrinkle prevention.
3. Give dry brushing a try for better lymphatic system function.
4. Drink more water!
5. Stretch at least 3 times per week.

... and etc. The sub-goals will change as I try things that may or may not work for me but I wanted an official goal out there that meant I wouldn’t start taking my routines for granted or settle into bad habits. With that said... time for a mask, dry brushing and stretching before bed!

​Until next time,
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