Life at Up Up and Away Investment Management International: Chapter 31 Disabled and down

Chapter 31

Disabled and down

Everyone has a breaking point. After being absent on her long-term disability for 4 months Stella Asterik returned to Toronto Legal at Up Up and Away. One afternoon Sally Self was in my office and criticized me for lagging on an issue. Something in me snapped. I just looked at her and calmly said, “You know the amount of work I have been handling these past months that Stella has been disabled. You know the medical conditions I have been suffering from. You offered no meaningful help. You just let me sink. I will brief Stella before I go this afternoon about what is outstanding. I will start short-term disability tomorrow.” Self’s jaw dropped. It was my time to strike back. If I was a mean person I might have called this revenge. I felt a tremendous sense of relief.

What options did I have? I could have quit but that would have meant no income.

Yes, I was close to retirement age but not quite ready financially for retirement. Going on short-term disability meant 100% of salary and benefits for 20 weeks. If things were not dealt with and given that there was a waiting list for the brain MRI and the cognitive testing that my neurologist had ordered I rather figured it would be two years, before all necessary tests would be completed. My goodness in many respects the medical system in Ontario was very badly broken That would mean after 20 weeks on short-term disability I could go on long term disability until I was 65.

I was grateful the medical system was so slow as the delays for the MRI and cognitive testing would give me time to heal. I told you earlier I was having difficulty accepting Dr. Wong’s diagnosis of depression but gradually I felt more and more lost and proverbially I just could not find my way home. I felt numb. Simple tasks seemed insurmountable. I encountered difficulty meditating as I had so many bad thoughts racing around in my head. I was irritable and impatient getting frustrated easily. I had lost interest in just about everything and anybody. I suppose that is what depression inflicts upon you?

I had a terrible experience with my psychotherapist one day when she asked me what I felt like if I had to return to work. A wave of chilling terror swept over me and I was ready to break down in uncontrollable sobs but managed to escape her office just in time. That was frightening. How much had work traumatized me?

Dr. Wong could see me heading downwards so prescribed an anti-depressant sertraline. I can’t say it made me feel any different, but it ripped up my digestive system. We tried another anti-depressant mirtazapine which was known to be gentle on the system. No such luck. After several months I had to stop taking them but my Beck Depression Inventory scores were decreasing. I was starting to feel better and then one day after being in a funk for close to a year walking to Dr. Wong’s office on a sunny spring day a genuine smile spontaneously took me over and for the first time in a long time it felt good to be alive.

Now it is difficult to bounce back from depression when you have lost that feeling of normalcy. The stress laden life I had led made me lose touch with what normalcy was but I was feeling far better than when I initially visited Dr. Wong. Was it the rest, the psychotherapy, the drugs, the mindfulness or the bright light therapy?

But depression is a cruel disease. Often the recovery can be marred by relapses and just when I was feeling better I had a couple of short setbacks that made me feel even worse than I was in the height of my depression.

Dr. Wong advised me depression is a chronic disease and for most people it reoccurs. As she said to me most of my patients will be with me for the rest of their lives. Now isn’t that a frightening thought?

I had to apply to Happy Insurance Company for my long-term disability benefits and was approved. A rare task to succeed with as insurance companies are in the business of making profits and not necessarily looking to your health nor making long-term disability payments. So, I was down to 70% of my salary until 65 at which time the long-term disability coverage would terminate.

Now most long-term disability providers have provisions in their contract that entitle you to long term disability payments for the first 24 months if your disability prevents you from performing the essential duties of your own occupation. After those 24 months you are entitled to disability benefits until age 65 if your disability prevents you from fulfilling the essential duties of any occupation taking into consideration your training, education and past work experience. For example, if you are a lawyer the fact you can flip burgers at McDonalds doesn’t mean your long-term disability benefits can be terminated.

Don’t forget to apply for Canada Pension Plan (CPP) long-term disability benefits even if you qualify for long-term disability benefits under your employer’s long-term disability plan. You must go through the application process and your disability must be severe and prolonged which prevents you from working at any job on a regular basis. Severe means you have a mental of physical disability that regularly stops you from doing any type of substantially gainful work. “Prolonged” means long term and of indefinite duration or is likely to result in death. I managed to obtain CPP long-term disability benefits in my first application. The odds of a successful application are rare.

I have been told your chances of success in obtaining CPP long term disability benefits are about 40% but you have the right to appeal. You also have the right to appeal from any private or employer       long-term disability plan denial of benefits. My best advice is to be precise and thorough in the application process. Unfortunately, your private long term disability provider will almost always have provisions in its long-term disability plan that enable them to deduct from their disability benefits payable to you any CPP long-term disability benefits you receive. Note that many insurance companies may force you to apply for CPP long term disability benefits.

Obtaining CPP long term disability benefits also makes for a far more difficult case for an insurance company to cease making disability payments and it also increases the amount of CPP payments you’ll be entitled to when you reach 65.

A bit of advice. Understand what the insurance company can require you to do to continue receiving long-term disability benefits. Most require your health providers to provide updates as to your health and to follow treatment recommendations made by your physicians. And cheating is not a clever idea. Insurance companies won’t hesitate to dispatch a detective for surveillance.

One more piece of advice. Insurance companies will pay attention to psychiatrists if you are claiming stress, anxiety or depression as grounds to be awarded long-term disability so get one in your camp. Notes and letters from general practitioners might be good enough for short-term disability claims for stress but are virtually meaningless for long-term disability.

Poetry Corner: ” Is it possible to go fishing after your funeral?”

Is it possible to go fishing after your funeral?

the gnawing worms
probably reached you by now
can you be but a pleasant memory
or are you there as I string you on my hook?

Robert K. Stephen

Poetry Corner

All in a Day’s Work

The surly vodka vapoured foreman
hastily retreats
in a flaming pink neon shirt
confidently sucking clacking dentures
and Mr. Milo racks up his total
of seven unfiltered Player’s
smoked and held in orange nicotine stained fingers in silent terror in a corner of the factory floor
Thank God for the small breaks in Life!

Robert K. Stephen


Life at Up Up and Away Investment Management International: Chapter 30 Off to the psychiatrist for Tony Hornet

Chapter 30

Off to the psychiatrist for Tony Hornet!

Who can ever believe they are to visit a psychiatrist? Well, I will admit for me it was time to pay a visit to a psychiatrist at a major downtown hospital. It was very odd getting off at the eighth floor of this hospital and walking into the Department of Psychiatry. Then waiting in the hall to see my psychiatrist.  Geez I sure had some problems to deal with but was being mentally ill one of them? You must remember as a child of the 1950’s and 1960’s the words divorce, homosexuality and psychiatry were nasty words!

Dr. Ellen Wong was right to the point and a very good listener. She looked you in the eye and only occasionally took notes. Within 5 minutes my initial freak out subsided. My comfort level shot up quickly. She asked a boatload of questions to get to know me better.

When she asked me why I thought I was there I told the story of my various health issues and how threatened I felt at work. I felt by continuing to work I was putting my life in peril. The volume and complexity of work was becoming unmanageable. I felt like there was an impending heart attack around the next corner.

To make matters worse one of my colleagues, Stella Asterix, was off on her third long term disability due to a chronic disease and guess who was filling in for her? I was coming home so exhausted I was in bed by 7 p.m. and waking up equally exhausted. It so happened that Dr. Wong sent me to an endocrinologist as in her blood test that she ordered there were low levels of TSH. The endocrinologist immediately pinpointed the issue as a well-known side effect of Amiodarone, subclinical hyperthyroidism, with exhaustion and heart palpitations being an unpleasant side effect as well as an increased chance of developing anxiety and depression. No medication was prescribed and in a month I returned to a somewhat normal energy level. I had been under much medical and work induced stress this was the last thing I needed.

I really admired Dr. Wong for focusing at least initially on some of the physical problems I was having. She set me up with a new GP for a thorough physical, ordered comprehensive blood tests, ordered a sleep test, sent me to a neurologist and a lung specialist. And to my delight no pills at least for the moment.

Before each session I had with her I completed a “Beck Depression Inventory” wherein certain questions about your mood and anxiety were measured and easily calculated. The higher the score the more likelihood you were suffering from depression and or anxiety.

I saw Dr. Wong each week and in week 5 she said it was her opinion that I was suffering from workplace stress and anxiety and possibly cognitive impairment due to the 14 years of atrial fibrillation resulting in micro-embolisms caused by the atrial fibrillation. I can’t say the stress and anxiety was a surprise but the micro-embolisms and cognitive impairment were worrisome. She set me up with a psychotherapist and a neurologist to do specialized cognitive testing that there was a two-year waiting list for. And she ordered an MRI for the brain for which there was a seven-month waiting period. And to top things off she got me enrolled in an experimental mindfulness session the hospital was offering.

About week 7 she told me I was suffering from depression and this was based on the consistently high scores I had on the Beck Depression Inventory and from her personal observations. This diagnosis was hard to swallow and I still wonder if it was true.  Dr. Wong also had me see her colleague for a second opinion which confirmed Dr. Wong’s diagnosis was correct. An initial neurological exam administered during the “second opinion” visit also confirmed my cognitive abilities were not where they should be but that would be confirmed or rejected by a more sophisticated test later.

Things at work were not going well. I revealed to Sally Self my psychiatric diagnosis and pleaded for some experienced help from our legal department in New York. Instead of experienced help I got a junior lawyer nice and eager but with no relevant and helpful ability. I pointed this out to Sally Self who said she could do no more

Things were getting so tight at Up Up and Away Toronto you needed to obtain the permission of the General Counsel of Up Up and Away New York to go on a business trip and probably to blow your nose. Morale was rock bottom. Stress levels were sky high due to a huge flow of project work. Up Up and Away New York had failed a U.S. regulatory inspection and was running scared and creating mountains of legal work to escape severe financial penalties. And me suffering from a litany of physical and psychological problems. The mindfulness had helped for a time but the stress was becoming so overwhelming I had vague thoughts of ending it all if you know what I mean and it was not quitting.

My psychotherapist patiently listened to my problems and gave encouraging advice. Her brother was working for a largecorp and running into severe stress issues so she caught on quickly. She was a good listener and we really talked out my work-related stress and what my options were. It was clear I was working in a very unhealthy environment. So unhealthy it was looking like it was deadly.

Canadian COVIDpolitics: Differing Responses and Differing Moral Codes

I have said it will take decades for historians, political scientists, psychologists, psychiatrists and academics to figure what the fuck went on the societal and political front during COVID-19.

Until then it is a shit show of interpretation to figure out if there is consistency in Canadian politics as far as COVIDpolitics rumbles.

As “Trailer Park Boys” is no longer shooting perhaps we should take a trailer park view of the recent shit show in Canadian politics and enjoy its rum n coke analysis of Ricki and Mr. Lahey!

In Ontario the rum n coke is flowing with recent events. Minister of Finance Rod Phillips took a 3-week vacation to St. Bart’s apparently only telling Premier Doug Ford several days after he left yet Ford did nothing until it would seem he was caught with his pants down after the media sniffed out Phillip’s cavortations at St. Bart’s. Phillips “resigned”. Ford apologized for not ordering Phillips back to Ontario. Philipps apologized for his “dumb dumb mistake”. At the end of the day Phillips is thrown under the bus.

Yet while Minister of Finance Phillips made a moral mistake of departing Ontario in the face of the politico-medico’s view of stay at home and travel for essential purposes he did not break any laws perhaps only politico-medico recommendations. No one was harmed. Sort of Like Kim Mitchell’s song “Drink a Soda and no one Dies”.

Yet under the watch of Ontario’s Merrille Fullerton (Minister of Long Term Care) and Christine Elliot (Minister of Health) hundreds of elderly Ontario residents have died in long-term care facilities. Yet they retain their ministerial posts. Premier Ford WTF is going on?

Premier Ford….time for an election. You knew Phillips was out of the province but you only apologize when you are “exposed”?

Now we have Niki Ashton of the federal NDP who was visiting a sick relative in Greece and the not so progressive federal New Democratic Party a socialist party demotes her from her shadow cabinet position. How gutless and politically correct.

Then there is Tracy Allard with the United Conservative party in Alberta. Off on a vacation only telling United Conservative Party Premier after she had left for a glorious Hawaiian vacation. Premier Jason Kenney at least had the guts to say it was his fault for not leaving a clear directive to members of his cabinet not to leave Alberta but said if you leave after I tell you not to leave you are toast.

One has the feeling there are many pieces of toast in the toaster and it is only when they pop up will they will be identified.

Canadian politics…..at least not the hatred of American political vitriol…..not quite yet!

Ontario COVIDpoltics

OK. Canada a beacon of reasonability. Supposedly Canadians are a harmonious nation which may be true in comparison to bloodbath of acrimony and lunacy in American politics that will soon come to an end as President elect Biden is finally sworn in despite the efforts of mongrel Trump to save his ego and destroy American democracy. To my American friends you elected the mongrel perhaps you deserve his dying barks. Actually, speaking of dogs Trump as the orange toad is the first president in the United States in 130 years to not have a pet in the White House!

Minister of Health in Ontario Elliot

Yes but here in Canada we are so much more civilized. We simply have exploited and abused our aboriginal population for close to 400 years. And we dare hold ourselves above the slave trader markets in Georgia?

Well at least as COVIDpoltics go on a federal and provincial level we have some degree of harmony in how to manage COVID. The Canadian federal government and provincial governments are acting is an almost harmony.

Merrielee Fullerton Ontario Minister of Long Term Care

Of late COVIDpoltics is starting to take its toll in Canadian politics but not on a federal vs. state/provincial level but within political parties.

Of late is Ontario Minister of Finance Rod Phillips who made the political error of heading off to St. Barts for a three-week vacation only telling Ontario Premier Doug Ford after he was enjoying the sun and waves he was enjoying a nice tropical vacation. This was at a time all citizens of Ontario were being told to stay at home perhaps like you and me having a lonely Christmas and New Year’s repast which I hope will never happen again in my lifetime.

It would seem that Ontario Premier Ford was notified by Phillips after he had left he was out of the province of Ontario. Premier Ford could have said haul your ass back to Ontario but he did not and for that he admits to yet another “personal mistake”. Seems to me he has made a few himself as regards COVID. Yet Phillips appears as a sacrificial lamb. He may have broken some moral code but no legal restrictions. Bad judgement perhaps but as Premier Ford let him cavort on the sandy beaches it was only when “exposed” that Phillips “resigned”.

On the other hand Minister of Health Christine Elliott and Minister of Long Term Care Fullerton cavort unscathed where under their watch hundreds have died in long term care facilities in Ontario. Yet Premier Ford protects and shields them. Phillips has killed no one yet he is axed from his ministerial portfolio. A lapse in moral judgement is more severe than ministers responsible for the health of seniors?  This stinks of hypocrisy and as for political accountability it should be good- bye to Premier Ford, Minister Elliot and Fullerton.

At one point many of us Ontarians had a grudging respect for Premier Ford. But this time it is clear he has thrown Phillips under the bus yet Fullerton and Elliot watch the bus run over Phillips with relief etched on their faces.

Premier Ford has had his sacrificial lamb but he might have better sacrificed Minister Elliot and Fullerton and perhaps himself. Time for an election you say?

Plagueolitics

We have all heard so much about COVID-19 from all levels of government throughout the globe. Incessant chatter it would seem. In my next serialized novel “Virus #26” you’ll witness my take on politics and COVID-19.

The full impact of COVID-19 on us as individuals, on society, on the medical establishment and on the political and ideological system may not be really known or understood for decades. But as a political scientist I can assure you universities will be crammed with COVIDolitics, COVID psychology, COVID history and on and on. Hundreds of books will be written of an academic nature on COVID–19 and perhaps even more encompassing and of value on Plagueolitics.

COVID-19 is just the current plague but there has been bubonic plague, Swine Flu, Spanish Flu, SARS, MERS and many more to come as humankind destroys its ecosystem so it may very well destroy itself.

Unfortunately (or perhaps fortunately) I did not pursue a career in academia. But perhaps there is time to obtain a PHD and MA in political science and teach it at some esteemed university? Of course, I am opening to receiving an honorary doctorate in political science and teach my new course “Plagueolitics 101”.

Here is my outline;

  • A brief history of humankind plagues
  • The politics of each plague
  • The role of government in each plague
  • The formation of the politico-medico elite
  • The role of politico-medico propaganda
  • The erosion of democratic rights
  • Did the media inform the populace or brainwash it
  • Was the scientific community subject to repression and censorship?
  • The glorification of “plague fighters”
  • The inaccuracies of the politico-medico party line
  • How Big Pharma exploited the various later day plagues 
  • What the plagues teach us about the past and how to avoid mistakes in the future
  • Who are the true heroes and villains?

Life at Up Up and Away Investment Management International: Chapter 29 The beginning of the end for Tony Hornet

Chapter 29

The beginning of the end for Tony Hornet

A high percentage of Canadians do not reach the unofficial retirement age of 65 as they succumb to a variety of health issues or due to ageism they are terminated. I suppose 11 years at CRAP and 19 at Up Up and Away Toronto took their toll on me. Too many heart pounding big deals, too many late nights and not enough sleep were taking a silent toll on me.

About three years into working at Up Up and Away Toronto I recall having a leisurely conversation with a colleague close to Christmas time. My heart stopped for second, then for a few seconds sped up but soon went back to its normal rhythm. Needless to say this was a disconcerting. It began to happen more frequently so I asked my GP about it and he seemed to brush it off as no big deal. According to my doctor the condition was called atrial fibrillation and many of his patients had it. If the heart did not start beating normally, he said very nonchalantly that I should go to “Emergency” and they would put me out and then I would undergo a cardioversion by way of an electric shock which would cause my heart to return to its normal sinus rhythm. A lack of compassion so common amongst physicians.

Well one morning about 3.a.m.my heart started beating wildly. It was my first full blown atrial fibrillation attack, so I hopped in a taxi and headed to Emergency. After about 6 hours of this wild cardiac ride they were about ready to put me out and give my heart a blast of electricity but just as soon as the episode started it then ended without the need for electricity. Being absent from work I had to spill the beans about this condition to Sally Self.

I suffered from atrial fibrillation for 14 years. Despite some awful drugs being offered to me the attacks worsened to the point they were at least twice a week and would last for 7-8 hours. This was extremely bothersome if the episode spanned into working hours and often it did. But I kept it quiet except for advising Sally and really suffered terribly. Atrial fibrillation may also have side effects of anxiety, depression and cognitive impairment.

The last drug I tried was Amiodarone which was a rate control drug. It was highly effective but highly toxic and dangerous. I was also taking Eliquis a mega blood thinner that made me a borderline hemophiliac. Those with atrial fibrillation are 4-5 times more likely to suffer from strokes due to clotting because of the stopping and starting of the heart. Clots blocking the flow of blood in the brain are the cause of strokes. Blood thinners are usually prescribed to avoid deadly or debilitating strokes.

I had an awful time converting to amiodarone as your system had to be clear of cardiac drugs for two weeks and the dosage of amiodarone required a month or so before being topped up to a full dose. So for 6 weeks my heart was acting up. It was unbearable. Upon retrospection I should have gone on short term disability during this extremely uncomfortable and challenging time.

There is a medical procedure called a cardiac ablation where the rogue heart tissue causing the arrhythmia are burnt off. Why my cardiologists failed to tell me was this procedure was relatively safe and extraordinarily successful was a puzzle to me until I saw an Ontario Hospital Insurance Plan policy urging cardiologists to pump out the drugs as a cardiac ablation costs approximately $60.000.

I think the breaking point was a possible mini-stroke I had. I was shaving and my shaving hand was not responding to what I wanted it to do. As well I had difficulty combing my hair. I phoned 911 and an ambulance transported me to Emergency. Was it a mini stroke? The neurologist ordered an MRI and no damage was found. Neither was there any firm medical pronouncement as to whether a mini stroke had occurred. Suffering the gnawing fear that a severe stroke was a possibility I visited my electro physiologist, the cardiac speciality physician that performs cardiac ablations, and asked for a cardiac ablation.

Several months later I had the cardiac ablation and the procedure lasted for 4 hours and over 100 burns were made to my heart. I still had to remain on the amiodarone for six more months. I am happy to say the cardiac ablation worked. On rare instances I get a few seconds of irregular heart beats. Unfortunately, research is surfacing showing that a cardiac ablation, because it is blasting heart tissue, may create “debris” that floats up in the blood to the brain causing brain lesions and cognitive impairment.

I must say sitting at my desk at Up Up and Away Toronto I began to think the stressful work I did was bad for my health. I felt a bit like a sitting duck waiting for a fatal shotgun blast. And the workplace stress was gaining in intensity.

After all these years no cardiologist or medical practitioner, save the neurologist seeing me after the mini stroke, ever asked me how I was feeling psychologically despite the fact there was unmistakable evidence that atrial fibrillation significantly increases the risk of anxiety, depression and cognitive impairment. I was feeling that the medical establishment had failed me. Speaking with friends in the United States cardiac ablations were far more common there than in Canada. When they heard I waited for 14 years to have one they were in disbelief. For them their wait had been weeks.

I explained to the neurologist following up on me after the possible mini stroke the stressful situation I was working in and if it was dangerous to me. The anxiety about another mini stroke induced by stress was beginning to gnaw at me. His response seeing my anxiety was that it was time to see a psychiatrist. Of course, hearing the word” psychiatrist” initially flipped me out but after a moment of reflection I accepted his referral to a hospital psychiatrist by the name of Dr. Ellen Wong.

I needed a month to recover from my cardiac ablation so had to go on short term disability. Boy I had a nasty “caseworker” from our short-term disability administrator, Happy Insurance Company. Aggressive in tone and attitude. My electro physiologist made the mistake of writing to Happy Insurance Company stating “if possible” Tony should have one month to recover. “If possible” meant two weeks to that bastard of an insurance company caseworker. Neither did Sally Self or our Human Resources Department give me any support to give me the month I required to heal despite a request I made for their intervention. At this point I was beginning to take matters personally. The apathy and lack of concern by Up Up and Away Toronto and Sally Self for my health was highly offensive.

To top things off shortly after returning to work from the cardiac ablation I was diagnosed with Essential Tremor or ET as it is known. What ET does is make you shaky. There is surgery but only for the worst cases. So yet more medication to take. The neurologist who diagnosed the ET found evidence of microangiopathic disease on the brain. This can lead to stroke and is an early maker for dementia and Alzheimer’s.

Having to deal with all these medical issues in a toxic workplace was becoming increasingly difficult.

Magnesium and stroke risk

The relationship between dietary magnesium intake, stroke and its major risk factors, blood pressure and cholesterol, in the EPIC-Norfolk cohort

Lucy K M Bain 1, Phyo K Myint 2, Amy Jennings 3, Marleen A H Lentjes 4, Robert N Luben 4, Kay-Tee Khaw 4, Nick J Wareham 4, Ailsa A Welch 5Affiliations expand

Free PMC article

Abstract

Background: Dietary magnesium could modify the major stroke risk factors, high blood pressure (BP) and cholesterol, but has been understudied in both sexes in a single population. This study aimed to investigate if dietary magnesium intake was associated with BP, total cholesterol (TC) and incident stroke risk in an adult population.

Methods: We conducted cross-sectional analyses in a case-cohort study of 4443, men and women aged 40-75, representative of 25,639 participants years of the EPIC (European Prospective Investigation into Cancer)-Norfolk cohort. The cohort included 928 stroke cases (42,556.5 person years). Dietary data from 7 day food diaries were analysed using multivariate regression to assess associations between quintiles or data-derived categories of dietary magnesium intake and BP, TC and stroke risk, adjusted for relevant confounders.

Results: We observed differences of -7 mmHg systolic BP (P trend ≤ 0.01) and -3.8 mmHg diastolic BP (P trend=0.01) between extreme intakes of magnesium in men, a significant inverse association with TC was observed (P trend=0.02 men and 0.04 women). Compared to the bottom 10%, the top 30% of magnesium intake was associated with a 41% relative reduction in stroke risk (HR 0.59; 95% CI 0.38-0.93) in men.

Conclusions: Lower dietary magnesium intake was associated with higher BP and stroke risk, which may have implications for primary prevention.

Keywords: Blood pressure; Dietary magnesium; Stroke; Total cholesterol.