Tuesday, January 27

I'm Messed Up

 I know many would agree to that statement, just because you know me, and have seen me do some weird stuff. Honestly, I think my body is just off-balance with all the changes in the dosage amounts, add this, stop that - I'll get there - then add in my body changing due to health, weight loss, and the meds. All I know is that last night, I realized I was a "Chatty Cathy" and just did not seem able to be quiet without blurting stuff (thoughts in my head) out loud to myself even. By the time I laid down, I felt somewhat like my body was on meth again. It's hard to explain, but just believe me. Had many, many cramps last night, but still managed around three hours. Cramps and bladder woke me at 3:30am, and I am just not tired enough to lay back down.

So some updates for you, as if my medical drama that is going on out here truly entertain you.... Yesterday was the weekly paracentesis, and 10.7 liters were drained. Was hoping this was decreasing each week, but not now. I do need to call today and set the appointments for each week in Feb. I met RM for lunch afterwards. We went to Black Bear Diner, and I had a BLT with fries, a side House salad w/Italian, and an iced tea. As usual, I really enjoyed the time with Mom one-on-one, and I know she does as well. Then on the way home, I decided I was going to make dinner using one of the crock pot recipes I had come across and saved. I swung over to Walmart to get the supplies (I didn't have all of them at home). Like most of us, I ended up spending more than I meant too, but they had long-sleeved, moisture-wicking tees marked down from $8 to $2 and wouldn't that look good on me under my Riders vest? Oh, and just some extra foods in general. The Wife needed her nutrition drinks, so that case was a bigger purchase. Looked at PS5 controllers, but at $80/each I'm not getting one for Youngest to use with the computer. Happened to walk through Jewelry walking through the store, and looked at watches. Found a nice one marked down from $23 to $11. Eventually I made the check-out, forgot to tell the clerk I had a watch up at Cust. Svc. on hold while I finished shopping so no watch. Might swing by today and try again - just for the watch. Got home, Son helped unload and I split up the spoils - that's dinner, that's other supplies I think we needed (or I know I did), here's you some soda and tea. Then I started on dinner, since it was nearing5pm or later.

The main ingredients for the dinner were summer sausages, cut  bite-sized, string hashbrowns, red peppers, green peppers, white onion then the mixers: Campbell's Cheddar Cheese, whipping cream, sour cream and shredded cheeses. I did a fiesta blend of the shredded, and also added some seasoning (basil, Italian seasoning, garlic, Worcestershire sauce, and some ground black pepper. Cooking said 2 hours high, but ended up being about 3 hours, just in time for the Wife to get home. Wife and Son said they enjoyed it, but it isn't a super wonderful food to ask for all the time.

Pickled up some Grill-o's Pickle salsa. Oh so good. I only had a bout 5 chips worth to try it, and I like it. Good - enough leftovers for a couple bowls. Might be lunch today (dinner from last night - and maybe the salsa, too). I do need to call for the weekly para appointments. Need to call Hyundai as I received an anti-theft warranty from them (for Youngest's car). Supposed to be a software update, and an ignition cylinder protector. I just need to find a dealer and time to take it in.

Hmm, seems my mind is drawing some blanks right now - or is that part of my issues with short-term memory loss, or other parts of the encephalopathy. Hopefully will get tired in the next hour and lay back down.

Other good news: PCP called about my bloodwork. Since my Rybelsus is not going to be happening according to my insurance, my PCP decided to stop the Farxiga (diabetes med). Makes sense since I am not taking any diabetic meds now, to get a better true non-medicated status of my A1C in 3 months. She also said my cholesterol was good enough that to stop taking the Atorvastatin. So now I am down to like 7 meds daily now. Talk about chemical body changes - take this, stop that. Sigh.

That's all I got for now. I am sure there was more to share, I just cannot get it to the top of the mind to write.

PeacE

PeacE

Sunday, January 25

Now I Am Too Busy ...

 I thought yesterday might be a decent day. Attended the District 3 meetings that lasted until about 12:30p (counting the lunch of subs/chips. Then I headed home. The Wife had gone into work today to try to get caught up on some of here paperwork, and didn't make it home until about 2pm - with lunch from Wendy's, so yes, I ate a chicken sandwich, gave the fries to the Youngest, and put the coke in the fridge for later. I was going to try to get some more yardwork done, there's so much to do yet. But I just couldn't motivate myself. My arms hurt. One from the shingles vaccine shot, the other from ache from the weed trimmer yesterday. Instead, I lay on the bed, and played crosswords for a couple hours.

Then I decided to get on the computer. The Wife's computer had "died" a few months ago, and we have not even really taken a look at it. Mostly because it is on the Wife's desk. We are talking like, hazard zone stuff. All over the place she has old paid bills, EOBs, investment accounts mails, miscellaneous diestrus that has just gotten piled up there over time. Most of it from her, before it quit working. Rather than suffer through a martyr speech about how she suffers to have to "clean her desk" when she has so much other stuff to get done....Grrr. I just started cleaning. I am not a quarter of the way through, and have done two bags of recycled paper stuff, and a trash bag of miscellaneous debris. The goal is to clear off her desk, and take a better look at the computer. It might be just a bad power supply, and I have another unit that is about the same age, the units maybe compatible for some parts. If not, I'll run it to Data Doctors, as they did me good last time.

Cleaning her desk lead into other things. With my Wife being somewhat of a hoarder, things tend to accumulate in all areas, and pile up. The Office is one such place, though she doesn't come back here much since her computer is down. But, started in on some of the beside the desks stuff, sorting. Two boxes for Goodwill, another 2 bags of trash and recycle, and over all, a little more space. What is bad is you have to organize as you go, and have no where to put anything, until you get through everything. I worked on that until midnight.

Slept good last night. Up to the cats making noise scratching at something that sounded like paper over on the Wife's side of the room. Went ahead and got up for my meds. BP 106/62 and Glucose 113. Think today will be spent at the Post. There are playoff football games, and I don't feel like working right now. I am sure this evening I will work on it some more.

PeacE

Friday, January 23

Welp, Something Got Done ... Sorta

" I woke this morning, probably around 9:30am, and thought to myself, 'Self, what are you going to actually get done today?' and self answered, 'I got some ideas." And so it started. Came into the office and got through the emails, the FB updates, my book searches and watchlists. Then I decided to do something. I went ahead and went to Walgreens, to get the shingles shot. I knew my PCP had okayed it for me, as it won't interfere with any medications, and I found out a few days ago, it is $0.00 payment to do it (preventative). I did not know, it was a two-part vaccine. I went ahead and did the first one, and the second can be done anytime after 3/20, according to the paperwork they gave me on it. Then I am done for life with it.

I figured, well, heck. All I have this morning is my handful of pills, and a gulp of juice. Might as well run on up the freeway five miles to my PCP and go get the blood drawn she wants to do. So I did. And a urine cup. By now I am a bit hangry, and thirsty, and sore! I know they said the vaccine shot could cause some arm soreness, but this is almost all my shoulder. I wave the arm around a bit, and kind of massage where I got the shot, and it backs off for awhile. Hopefully only a couple days of it.

Seeing how now we are heading towards the 11 o'clock hour, I determined it was time to eat, and plan my afternoon. Most Fridays I go up to the Post. Today I decided to do the regular, and on the way, stop at the gyro place I did for lunch yesterday. I didn't opt for the lamb or chicken (though I still want to try those) but went for the beef shwarma again. Then off to the Post. Sat out back and ate while watching a couple members spread that garage paint/epoxy over the patio area that they had not finished yesterday. The smoking area is looking nice now! Painted tables matching each branch of service, new looking floor paint. And they have plans to have a mural done on the back wall, but I do not know what design/image they want to do.

After a couple hours, and pretty much just a bit over one tea, I decided I was done there. Barely after 2pm. I just wasn't in the mood to sit there today and listen to the talk. Nothing bad, just wasn't feeling it. So home I went. What will I do next, I wonder....

Well, I have several things in the works. I did get the trimmer line, so I went ahead and loaded up the spool on the trimmer. Went out front, and geez, my yard is crap. Wife has flowers/bushes/whatever planted up near the house (which I don't like) and the grass around them, and about 3 feet out, is like a foot high plus in areas. Rest of the yard had been last mowed maybe a month or so ago? But it needs it again. Much of the Bermuda grass that grows here, acts like that crab grass, grows out, plants again, moves on. Had quite a bit coming off the yard around the edges of the driveway, as well as the crap growing up from the cracks in the drive. I did the front walkway (trimmed the edges of the walk to the driveway) and knocked out a section of the driveway that didn't have a vehicle on it currently. Then I put on the knee pads and got down to cut/pull/scrape the grass roots from the cracks to help prevent them coming back so fast. After awhile, I got fatigued. Didn't even get a fifth of the yard done, but tomorrow afternoon maybe I can get another hour or so out there, with help from the Youngest.

Tomorrow morning I will be up for District 3 meetings at the Post. Start at 9am (instruction and audit) then meeting from 10-12, followed by a lunch my Aux puts on for the District meetings as they are held at our Post. Last quarter it was pizza - maybe do some kind of sandwiches or pinwheels this time. I don't know what was decided.

I read over at RM's blog that she took today and Monday off from work. I didn't get a chance to reach out to her today to possibly meet for lunch, but it sort of sounded like she had things she was working on getting done while off today. I should reach out and see about Monday for lunch. Gotta figure out where though. Sunday is clear for me. Monday is another paracentesis in the morning. The rest of the week has no doctor appointments, bloodwork, VFW meetings, or anything else I know of. First week since September I think, that has been that clear.

Had to go back and read a couple posts put up recently. My Rybelsus (diabetic medicine) issue with the insurance and doctor. Well, Monday we did an A1C and it was at 5.3, plus the prior one I had (think September?) it was also 5.<something>. Seems the insurance no longer wanted to cover the medication as my A1C numbers had dropped so well into the good range. My PCP wanted to keep me on it until my next appointment (3 months) and re-evaluate, possibly remove it. Well, PCP emailed me, since insurance won't pay for it, and I have been off it already for two weeks, we will just see how my numbers are at the next appointment. So one less med already....

So this insurance coverage for facility for transplant... I know what Banner called and said. I tried looking online, but could not confirm through Mayo or BCBS if they were in network. It has to a "Blue Distinction Specialty" facility, and I tried looking again just now. I see some of those types of facilities here in the Valley, but none specifically saying for liver. I guess something to talk about with my liver doc next month - maybe I could get the prelims done at St Joe's instead. I don't know. I wish you could walk into the insurance and talk to someone face to face with questions about coverage for who and where and what. Same with the SSA. Or any Government place, heck, for many places.

And that is about all I have today....

PeacE

Thursday, January 22

There Has Been An Unexpected Change ....

 ... to everything I do, it seems. The biggest one being the time at which I set out to do said 'thing'. With some of the bad sleeping nights, I may not get up from bed before 11am. Other days I am up earlier, but the getting motivated thing to do something... well, another story.

Yesterday I was at a decent morning hour. I had wanted to be up, gone to the Dr.'s (bloodwork in office), stopped by Walgreens for the shingles shot, and back home before 10:30am, the scheduled time for my phone interview assistance with SSA for disability. Well, I didn't make it out of the house in the morning.

Near 10:30am I got a call from Banner Transplant. This is the referral the Liver Dr. made for me, to have them schedule an appointment to see about getting preliminary tests, paperwork, etc. out of the way, in the event I need a transplant. I set an appointment (March was the earliest) and had to go as another call (SSA?) was coming in. 

Missed the second call, I think I hung up as I was trying to end one and get to the other. Call log shows it was Banner calling at the same time as I was on scheduling. So I called back, left a message in case they need more info from me.

Finally the SSA call came in (on time). As I sat here at my desk, I have medical reports, discharges, procedures and results, W-2s, birth certificate, my medical notes journal - I'm prepared to load them up with info, and to scan/send anything they need. Nope. Thirty minutes later I was off the phone, shaking my head at the time frame to be approved (six months). Six months? Hmmmm... I have a friend at the Post that works in a similar field. She does interviews to offer suggestions/decisions for continuing coverage for some other Government welfare-type program. She said once I got the app process started to let her know, and she knows of a way I could speed up the decision, due to my medical issue. I'll have to get with her this weekend.

Later on, I get another call from Banner, this one the hospital scheduling for my paracentesis scheduled on Monday. Registration and Admitting do not communicate, and their computer system that is there to link and share patient information is non-existent. So had to give her the insurance information (again). She couldn't check my current benefits, so asked to call me back. Sure. A short while, she's back telling me my insurance still says I have my full deductible to pay (true) so my patient responsibility for Monday is $1710. Just like the past three Mondays. I told them I would make a minimal payment ($500 like last week). That's settled for now.

Later in the day I get another call from Banner Transplant. Seems they are not covered through my insurance (yet Banner hospital is?) and it would all be out of pocket expenses (fat no). She mentioned that the Mayo Clinic is the only one in the Valley that is under my insurance. Okay, so I did leave a message to the Liver Doc about this, and also the prescriptions my PCP wants him to be in charge of the refills, dosages, etc. as it is his specialty. I did some looking online, and I cannot find through my insurance or the Mayo clinic, where they are participating with my insurance. This may be a fun one if I have to do a transplant, which no doctor has said I NEED or HAVE to have ... it's a 'just in case'. March would make my 6-months sober, and eligible for the list.

This morning, I was going to try to do the lab thing and the shot, but ended up sleeping until 10:30am almost. Got up, checked my emails, and was thinking what do I need to get done. Decided I was going to the Post to work on the Riders meeting minutes, and maybe the agenda for the House in a week or so. Made it to the carwash when my buddy J asked about doing lunch, with another of our friends, D. So we three met up. Tried out this gyro place over at 35th Ave and Greenway, NW corner, that had been there for years, like 15+ years. It never looks busy. J had gone there back earlier in the year and mentioned it, I just never made it there. Oh my! I got a Beef shwarma pita, with fries and a drink, for $16, and it was awesome! I was worried that there would be some weird Greek cheese or sauce that would permeate the food and I wouldn't like it ... I was wrong. I want to go back and try the lamb and chicken as well.

It was good to catch up between the three of us. Then I was off to the Post. Finished the minutes, emailed them out. Decided the agenda could wait until next week, in case new business comes up. I headed home about 4pm, and here is where you find me. Today's mail: SSA contact of my scheduled phone appointment for 1/21 at 10:30am. Right on time to remind me (snort).

Tomorrow I don't have anything on my calendar. I should get out front and work on the yard. I did get weed eater line for trim work, and an action rake to work on removing the grass/weeds in the section between the neighbor and our drives. Physical work. I see many breaks in my future (if I actually motivate myself to do it).

PeacE




Tuesday, January 20

I Don't Like ...

 ... so many things, but today I have that in particular is on my mind, or rather, my stomach. Waking this morning after a night of up and down due to leg cramps, I found myself just wiped physically. I had plans ... but that didn't happen.

Saw the PCP yesterday, and we played catch-up on stuff I have had done since late November. We discussed which doctor(s) are in charge of dosages/renewals of which medications. She okayed me to take the Shingles shot. She also wanted some blood. Seems every doctor I see wants bloodwork done. Sigh. She is having the staff look into the Rybelsus issue (still don't have and it has been two weeks). I asked if I could quit taking, as my A1C yesterday was 5.3, and it was under 6 last time as well. For two weeks of not taking it, my glucose numbers have stayed consistent. She wants to wait until our next appointment, and re-evaluate. Maybe one less med soon...

Rushed over to the hospital for the paracentesis. Drained another 9.5L and sent me on my way. As always after these procedures, I hurt for a couple days. The organs just feel like they are hanging in there without all the fluid pushing them wherever. Takes awhile for them to adjust back to normal. Also brings on some nausea at times.

Then it was off to the pharmacy. I picked the non-special order medication the Liver Doc prescribed. It is a liquid, that once it gets to the colon, helps as a laxative to help push out the bacteria causing the ammonia causing my encephalopathy. It says it takes 24-48 hours to begin working, but just in the last hour, I released a convoy of RVs sump tanks, and I think half my internal organs. 

Ran to the grocery store to get a select few items (yeah right). I joined a website that you sign up to try certain products, buy them at the retailer you choose, and enter the receipt online. They supposedly pay you back a rebate portion. So, I found 2 of the 4 items I was looking for, and a cartload of other stuff. I admit, I goofed. I went to the store hungry (fasted for possible bloodwork, which I didn't have time for). Anyways, went home and unloaded, then shortly headed back out to get my hair cut and head to the Post.

The Riders meeting went well. Interim Director had some great ideas, and the Chapter cleared up some unfinished business. Overall, I think we will be okay.

Today, I was going to get the bloodwork done, followed y a trip to the pharmacy to get the shingles shot, and a last stop at Lowes. Seems our bathroom toilet flapper wore out and isn't seating properly. Three minutes if that to fix, but need the flapper. After waking this morning, I pretty much knew I was not going anywhere today, even though I want to. My buddy J says there trivia night up at the pub he is going to now. Maybe later I will head up there. I don't know. I don't much care for sitting at the bar drinking soda, watching everyone else get drunk.

Tomorrow morning I have my phone interview with SSA for my disability application. Hopefully it won't take long, and I can get today's stuff done tomorrow, maybe.

And now you are caught up.

PeacE


Sunday, January 18

Getting Into the Week

 Figured I might write this one up a little early. I have an appointment with my PCP at 9am, and I am planning on going earlier to see if she is able to get me in sooner. We will be playing 'catch-up' together as we talk about what has gone on since my last visit in late November. Also, updating insurance, medications I am on now, procedure results I have  (endoscopy results including the biopsy they took) plus any that are planned coming up. Which, at this time I do not have any excluding the paracentesis when I do them. I think I mentioned that after this week, I may try going to two weeks at a time, versus this one week. I don't think there will be much else for her to really address, aside from wanting to refer me to a cardiologist. Which I will do, once I got this under control. Actually, I should start now, since I am nearing the deductible limit, that way more of the year is not out of my pocket.

Anyways, so I have the PCP in the morning. No idea if she will want any bloodwork (they do it in office) so will be fasting. From there I have to head over to the hospital. Thankfully it is only about 15 minutes from the PCP. I have an 11am paracentesis (need to be there early for valet parking, as well as check-in). Heh, so here's one... At one point towards later November I think it was, I had a paracentesis scheduled. The hospital called me up to verify my information, insurance, blah, blah, which they should have already had on file like a trillion times by now... back to the point. Hospital called, and after verifying info, stated that my patient portion for the procedure is $380 (I think that was the figure). I said okay, as I was willing to pay it. But when I went to the appointment, no one collected it. Moving forward, this past week the hospital calls about my paracentesis coming up Monday, and tells me my patient responsibility is $1710 (haven't quite reached my deductible that I know of, but am so close that I am not paying this). I told her I couldn't afford that. They want to do a payment plan, and have me sign a contractual agreement for it. Again I said no. I am willing to do up to half the amount, as I want the insurance to catch up on the submitted bills, so when these hospitals and doctors log-in to see what my patient responsibility would be for a procedure, it is up to date. We will see what happens tomorrow.

After that, I have the afternoon free. I am debating heading over to RM's, but I know she will be working, and I don't want to sit with PT all afternoon. I joined a new website called Social Nature, and it is one of them shopping for items at the store sites. I told it what stores I shop at, and it brings up deals for products at those stores. I saw tonight it was updated, and had some salsas, and sauces in there, so I added them. Smaller product size - I think the largest is up to 16oz. Maybe I'll run by the store, grab these items, go to RM's, share one or two. I dunno.

Post opens at 4pm, so I will be heading there by that time. I do have a Riders meeting at 6:30pm there, that I am really not feeling like wanting to attend. Our Director has stepped down from the position (and his Trustee one with the Post) due to personal reasons, which I really understand. But I feel it leaves our chapter in a bit of a lurch. Still so new, we barely have members, let alone one that meets the requirements to be the Director (voting comes up in May). Our Vice Dir. will step up and fill the position for now, though he said he has no idea what he is doing. I told him I would help guide him. Our Post commander is supposed to be there at the meeting as well (he is our Treasurer for the chapter, too). That will help explain what is going on, and hopefully, give us some leadership guidance as to what we need to focus and get done right now regarding this situation. It will be interesting, but I still don't want to go.

Alright, enough from me....

PeacE

Saturday, January 17

Wasted Day?

 Up early this morning. Seems the Wife had told me about an appointment, but I had totally forgot. So I guess her's is possibly the first one, as she says we need to leave by 7am. I'm only going because she asked me to. How can I say no after her going every time to the ER and stuff with me?

So, I am hoping that won't take long. I had picked up some weed eater line and an action rake this past week, and I was hoping to get some yard stuff done. I can do it, just tire out a little faster, and need more breaks. I might be too sleepy tired after the appointment, I may come home and go back to bed. Then I will end up sleeping until afternoon, when it will feel too late to start anything on the yard. Yeah, see the crap that goes through my head.

No big plans this weekend. I am keeping an "eye" on how I feel over the next few days. Want to be sure this new medication doesn't do weird things (though the side effects on the paperwork weren't major). I really hope that the beginning of this week brings my insurance company to see the light and quit fighting my medications. Starting into two weeks with my diabetic pill (still). I have one to pick up (not a new one) and I think yesterday they said there were two not ready to dispense (<30 days since refill) and two with insurance issues, that I am told are between the doctor and the insurance. I just want my meds and get better. Nothing big.

Welp, almost time to go, so I am out of here....

PeacE

Friday, January 16

I Must Apologize ....

 ... to anyone that stopped by after reading the last post, expecting an update to my Liver Dr appointment. In my meager defense, I offer up that there was enough information and next steps, that I needed a bit of time. Time to let myself think about it, "soak it in" knowing this is my problem. And let's not mention the time it took to type it out on my phone to let certain friend/family members know. I typed it once, then pretty much copy/paste to everyone minus a couple personal changes in text. But YOU don't know... so, I'm going to lay it out here. Besides, I think it will help me focus on getting over accepting this is the solution, and get busy doing it.

1.) Dr. was happy the amount being drained at paracentesis "seems" to be getting less (at least over the last couple weeks or so). Still too much, and wants me to continue weekly. Most of that is for my comfort (the weekly part) but if I really wanted to, I could change my appointments to longer periods. After this coming up on on Monday, I pretty much reach my patient expense limit, and deductible. I found out, that my patient responsibility amount, to only the hospital for the paracentesis (not any doctors) is $1710. Each. Last year, they had me prepared to bring in a payment of $371, so I must have been at last years limit at that time. But $1700?!? Crazy.... but I'm going to keep going.

2.) New medications. The Wife was able to go with me, and we brought up some of my issues with "brain fog", short-term memory issues, and my "bad days" where I Am lethargic and sleep all day. Dr prescribed a couple more medications to help with that: Lactulose and Xifaxan. Lactulose is a laxative fluid that helps the body pull the ammonia out of the system, and help the body rid it by bowels, instead of urine. The Xifaxan is a stomach antibody to help fight the bacteria that creates the ammonia. Both are to help clear up the encephalopathy ("brain fog") I have been having for awhile. Lactulose is a special order prescription, so they contact me and mail it to me. Weird.

3.) We discussed briefly a TIPS procedure, that inserts a stent that helps direct some of the flow of fluids to the liver, to basically be sent back through the body. It reduces the pressure/stress on the liver. However, at this time the Dr wants to wait a couple months. With the recycling of fluids through the body, the risk for other issues coming from something in the fluid is higher (like a 2nd merry-go-round for a bacteria). I agree to wait a couple months for further discussion.

4.) Transplant. Oh boy. This is one I really do not hope I will need. Obviously it is more of an end-stage, and all those requirements, dotted i's and t's, and a viable donor is all needed as well. To even get on the list, one has to be sober for six full months (that will be March for me), and pass all their rules/requirements/tests. I am not sure what all is involved in starting that process, but that is what we are doing. The Dr said it is better to get the preliminary processes of the transplant out of the way, as if the need were there for a speedy transplant as soon as March hits. I ain't that bad off as of right now. But Banner University will be contacting me to setup a starting appointment for paperwork and the basics, and who knows from there.

Overall, my good days have been coming more frequently than the bad ones. Still having issues with fatigue (constant) and nausea (comes and goes - no pattern), and of course, the fluid build-up in the abdomen (hopefully getting better - as in reducing). Guess for now, we will see how these two new meds affect my system and go from there.

Welp, that's pretty much what all I can remember from my head. My notes pretty much have the same stuff. No idea what the Wife would offer up, as she catches important details I miss - that's why I take her to the liver doc. 

Until next time,

PeacE

Thursday, January 15

Easy Day with an Edit

 Late this morning I have an appointment with the Liver Specialist. Followed by a blood draw in his office. Yesterday I was thinking, it will be done by close to noon, maybe RM could meet up for lunch at Red Robin. I texted, but no answer yet. I know she had an appointment today, as well, but not the time, so she could be at that right now. So, maybe today would not be a good day...it was just a thought.

At near 8:30am I woke from my cat nap to see that the Wife was still in bed. Thinking she had overslept, I woke her. I guess she is coming to my appointment as well. I wasn't expecting that. Well, she could join us for lunch as well - but no PT. I asked when she was going to tell me she was going, and she said she had. That she has the full day off work for this appointment, as it is one of the more important ones, and I had asked her since we made it last month, to see if she would go with. I never seem to know the right question to ask, or to give information that isn't specifically asked for. Plus, she'll help me remember until I can get it in writing (my med journal, or whatever). Cool. Added bonus.

After the lunch (because I am fasting, I will need to eat ASAP out of the appointment) I suppose I need to run by Home Deport and get some weed-eater trim line. Thinking about an "action rake" as well. At least that is what they call it. I call it a hole rake, or a loop rake. We need one to help get the area between our drive and the neighbors. It is only 4-5 feet wide, and from the street to the fence 20 yards maybe? Well, the neighbor had some hard times, and ended up getting their house basically remodeled and re-wired. At the same time, being elderly I suppose, her Daughter and husband were moving in as well. She had her driveway widened a car width with paver stones. Only, it went over the existing drive as well, and now there is a 5 inch drop from her drive, to that strip of land between us. She complains if the grass gets over 4 inches, and that it 'trips her up' and we wouldn't want her falling on our property due to negligence. Half that ground is covered by the sand/soft dirt the work crews used when doing the drive (over a year ago) so I figure just scalp the ground. Eventually we want to lay some little river rock there. Work in progress.

Just got the Wife up. Need to leave here in about an hour to be there early to make sure they have my new insurance information. 

The hospital called me yesterday, regarding my appointment on Monday (paracentesis). They ran the 'patient responsibility' from my insurance, and gave me a figure I need to pay out of pocket for the visit. Mind you, this will be the third one this year already, and at the others, they could not access the site (or whatever) where they can look at my benefits and determine deductible/pt responsibility. It is basically $1710.00 for Monday's draining. Triple that, and that is just what I owe to the hospital facility already this year (not counting doctor feed within the hospital yet). Obviously, there is going to be a bit of a payment plan. Getting closer though, to the $4K deductible/$6K OOP.

Anyways, need to move on to some other things this morning. Watch for maybe an edit later, of what the doctor tells me. Or I may have to wait and figure some things out first. We will see....

PeacE

Wednesday, January 14

My Chemical Romance

 I don't know if there is actually anyone that reads this drivel, that would actually know the band in the Post title. Maybe have heard of the name, but the music as well? Doubtful. Either way, those were the first words I thought of when I sat down and asked myself what should the post title be today. Hidden meaning? Double entendre? Maybe a little of both? Well, let's take that short walk that was yesterday, and maybe you'll figure it out ...

Got up 8am and did the routine. I double-checked the SSA website, directing me to this particular SSA office, to verify address as well as they are accepting walk-ins. I don't get over to the NE area of Phoenix that often, and I still have no desire to do so. I was still a few miles away when - road construction. Three lanes into one, I'm still, literally, almost a 1/2 mile from the light (of several to go through). No, no, no. Took a side street, went up to the next main road and continued on. Got there in 5 minutes from there. Roll up to the SSA, seeing lots of cars and several people in the parking lot. Yep, surely they are open. Start to go inside, and am stopped before I even get to the security check-point by a gal handing out a flyer. They are NOT taking walk-ins. Physical interviews are for only extreme situations, otherwise you have to call some number and set up either a video, or phone, appointment. Sigh. I asked what the time frame for an appointment for the disability application process, and she said a few days. I sat there in the foyer and called. Robo-witch told me it was going to be a 30 minute wait. Nope. Not here. I left.

On the way home, a different route as to avoid all that construction, led me into ... more construction, just as bad. Finally got to 'My side' of town and picked up scrips for the Wife and I. Got home and made the call to the SSA. Forty minutes later, I have a phone appointment around 10:30a on the 21st. At least it is only a week out. So I am tossing all the stress/worry/angst over the disability filing out the window for right now. It is completely out of my hands until the 21st.

Attended the general Post/Aux meetings last night. I was pulled into several conversations before and after, regarding the Riders Director stepping down. I had no answers. All I heard were speculations. Either way, come Monday's meeting, I am sure I will be stumbling a bit as we try to see where the Director left things (gave me no paperwork of anything for the Chapter). I was a bit relieved to hear our Treasurer, who is our actual Post Commander, will be at the meeting, and will be much help in helping us re-focus. I also checked with the Adjutant as to monthly reports - as in finding out what ones we are supposed to turn in. I am guessing that is a role I will take over, since of the two reports, one is my minutes. Sigh. More work.

So you sorta see how my day went, which is a bot crazier than normal for myself. I was a bit frazzled last night. Tried sleeping for a couple hours - nope. Took one of my edibles, and I can still feel that thing working this morning. One of the scrips I picked up was for me, and was one of the ones I ran out of last week. So I took those pills right away. Still no Rybelsus. When I asked, was told it is between the doctor and the insurance. Just great. Sigh.

Popping some pills that I was off of a few days, while already feeling off-balance due to being out of 2 scrips, throw in the remnants of the workings of my edible, and all my medical in general.... yeah. It's Chemical alright.

Had an email come in late last night from the Daughter. It is that time again, and I urge you to hide. Girl Scout cookies are out for ordering, and my Doodad has already hit me up via text and email. Doesn't she know Papaw isn't supposed to have that stuff (the sugar-free ones are nasty). I am sure the Wife will be buying a couple cases, and taking many to work.

Welp, I think I got nothing else for now. You know what day of the week it is ... and I have nothing planned (I hope - need to check my calendar and notebook).

PeacE

PeacE

Tuesday, January 13

Quick Update - with an edit

 Yesterday was another paracentesis. Drained off 9.5 liters today. I weighed in afterwards and am down to 260 lbs now.

I am up somewhat early (for me) to head over to the SSA to see about getting my disability claim started. I wonder if I should call first... I dunno. It ain't far either way, and I need to go out to pick up  scrips anyways.

The Director of my Riders chapter has stepped down. I'll talk more about this later when I have more time to write...

EDIT: So I made it over to the SSA office. As soon as I walk in, I cannot even pass the security checkpoint, they have someone there TELLING everyone an appointment is now required, regardless what it says online. Sigh. She offered me the seating in the entryway foyer in order to sit and call, where I may get an appointment right away. I don't think so with my application....

So, after calling and finding out there is a 30 minute wait, I figured I would do it later today. Headed to Walgreens to pick up a couple meds for the Wife. Nice surprise they had 2 of mine ready, but only one was really needed right this minute. My Rybelsus... the insurance, doctor, and pharmacy are all fighting over giving it to me. According to the pharmacist, right now it is the round for the insurance and my PCP. All I know is, this is my main diabetic medication, and it has now been over a week since I had it. I wonder... I see my PCP in another week, and if my numbers are still down, could I just drop the rybelsus now? After all, we would have the numbers for at least two weeks without it. Who knows.

Saturday after our Riders Run, I had exchanged some small chatter in a group chat of some of us Rider, talking a bit about the day. The Director had asked how many, etc, and I had answered, then was distracted by other texts, msgs, etc. Last week, I had told the Director, and Asst Sec., that I would step back into Secretary at our next meeting as I was starting to feel better. Got an email from the Asst that she had left the Riders binder at the Post. I keep a divider bin with much of the physical paperwork for the Riders. She had it when I stepped down a couple months ago. I thought no big deal. I happened to go back into the chat group, and see that he Director had other texts Saturday I had missed - the last being he was stepping down from Director for personal reasons. Due to issues I have had with this guy, I don't know to be happy or not. Our Vice will step up until voting (May). The whole thing has already got people talking, but I am trying to stay out of it all.

Started the call to SSA prior to typing in here. I'm still on hold. Sigh.

PeacE

Sunday, January 11

Ghost Hunts and Motorcycles

 I was browsing back through the few recent posts I have put up this last week, or so, and noticed From Friday night's goings-ons, I forgot to share the part of the night I thought was weird. So, you now have a teaser for that coming up in today's post. Probably followed with a bit of the day yesterday as my Riders Chapter did the Frozen Throttles Run. Then, like always, I think I will round it out with plans for this week. In other words, not much more than a regular post, and now you know all this is going to say, you can move on and quit wasting your time today.

Friday night was the "Ghost Hunt at the Post" event put on by the Post. I heard yesterday, that the whole thing was supposed to go until about midnight, but it was past 2am before it ended. Allegedly, no one that attended is talking about "who" or "what" they may have seen, so, is this true stuff? Anyways, earlier Friday evening, after having dinner with RM & PT, I was talking to Stace, as she had said she had an extra ticket for the Ghost Hunt part of the night. She was offering it up to someone else that really wanted to go (limited seating slots available) but turned out, she couldn't get a sitter last minute, so Stace offered the ticket to me. This is probably just a short bit before 9pm - Hunt starts at 10pm. 

Throw in a little backstory part - earlier in the week I had talked with RM and as usual she had asked about the Riders Dinner this week. I glossed over about what we were having, and I was hoping for more people due to the Hunt...which is where I got RM's "holy" look. Now PT & RM are ordained ministers. RM preaches at a couple places here in the Valley during snowbird season. I don't recall exactly what was said between us, but it basically me mentioning to RM to not start on the holy, spiritual thing of angels and demons, and psychic things like this are nothing but temptation to trouble. And she did not continue, but I knew what she was thinking. And earlier too, when I mentioned to the Wife about the Hunt (prior to me even knowing about the ticket) her words were "Don't invite anything home". How do you fell about that?

So, it's around 9pm, Friday night. Psychic is off doing the private readings people actually signed up for (ad paid money). Hunt is not for about an hour. I start getting a headache. One of those stress ones, that start on the neck and from the back, slowly envelopes your skull. I have been told to not take Ibuprofen and Aspirin and  Acetaminaphen (liver has to break them down) whilst trying to figure out my liver issues, so there is no relief that way. I just deal with it... as I did now. I switched my drink from tea to cola. About 5 minutes later, nausea hits - strong! within moments of that, my pulse kicks up, you know the one, that beats at your chest like it is going to bust through and you feel anxiety that speeds it up more. I turned to Stace, told her to give the ticket to someone else, I was out. I went home. I hadn't even gone 1/2 mile from the Post, nausea gone. About halfway home, pulse settles. By the time I got in the house, the headache had not completely gone, but faded to where it was more of an irritant than anything. Was I being manipulated to leave? Was I being moved to avoid something bad happening (let alone to me)? Just a weird story part to the tale. Yes, RM, I am sure I can figure out what you are thinking about it....lol.

The ride yesterday went pretty good I thought. Granted, this is the first one I have ever been on, and I was in my Rav, not on two wheels. We did KSU at 10am to a bright and chilly morning of about 43 degrees. We had 5 guys from our chapter (best turn-out yet) and three others along. We headed north to Prescott. There are a couple steep hills going north of the Valley towards Flagstaff. One of the riders started lagging as we hit the first one. Seems his bike was "just small enough" it didn't have the power to hold the speed limit (75) as it went up the hill. I stayed behind him until we caught up to everyone. We made out first stop (about 30 riders from all over were there) hung for a bit. They had a grand opening so had burgers and hot dogs with chips for free. It was still 43 degrees (there is about a 10 degree difference between Phoenix and our closest urban neighbors year round - Tucson, Prescott, Payson especially). Had a dog, and eventually we readied to move on. another group of riders from Chino Valley joined us as we went to VFW Post 541 Bucky O'Neill. First time there, as typical for the town, the place is well-worn looking, but comfortable. Hung out for a soda or two, and we were off again to Camp Verde VFW Post 6739. Nicer place, bigger, on a mesa so it overlooks a part of the Verde Valley headed out of town (pretty). Couldn't stay long as the riders wanted to be as close to Phoenix before full dark, so we hit the road near 5, and made it back to the Post around 6:15pm. Had a good day and enjoyed my time. Met a bunch of riders from different groups and places. So, for being only like the second ride run we have done, this wasn't bad I thought. ABATE of AZ sponsored with us, so I know getting the word out was more them than us.

This week: Paracentesis on Monday. Liver Specialist on Thursday, followed with bloodwork for his office. Medically, that's all I have. Tuesday (I should) need to get over to SSN to get that Disability paperwork started. Joy. I think that is about all I got off the top of my head this morning.

PeacE

Friday, January 9

*GASP* I Was Wrong ....

Putting this post in on Friday night, as tomorrow will be a long day with a fairly early start for me. But we will get there ....

I had mentioned before about tonight being the Riders Monthly Dinner, and this Ghost Hunt/Show they are doing at like 10pm. I thought maybe we would pick up additional meal sales, as people come early (they had to purchase within a limited number of tickets) as they get off work, and haven't eaten dinner yet... sounds about right? Well, we only sold 16 meals tonight. The gal that was making the garlic bread and possibly bringing a "cheap dessert" (like cupcakes from the store) totally zoned about tonight, so no garlic bread to go with the spaghetti. The Director made (or rather bought then cooked) plain meatballs at home and brought them in, and we used a big ol' bottle of Ragu for sauce. Threw some noodles in the pot, and were off! I personally had picked up 4 bags of salad. Last month, we did about 20 sales, and went through 2 bags, so I figured if we popped out a 35+ number of sales like most months (pre-holiday period) there wouldn't be much spaghetti or salad left over to worry about. No. Instead I have 3 unopened bags. I know I can only get through one bag, before the others start turning to mush and brown stuff, so I ended up giving one to the bartender, and one to my friend's daughter. At least they will eat it.

So the meal came and went. RM and PT came up, as usual (which is nice). Another couple had sat at our table as well, so we didn't talk as much personally as we might normally, but we still caught up. PT's mental facilities are definitely wearing down. I felt he kept asking me questions that he should already know the answer to, or know at least I don't have the answer. Maybe it was just my observation, as I admit, I always get 'testy' when PT comes around. Irritation doesn't begin to hardly describe it. Oh well.

Tomorrow I am going on the Frozen Throttles Run our Riders are putting on with ABATE of AZ. Charity ride to Prescott to Full Stop Motorsports (a motorcycle custom/tire shop) grand opening (friend of one of our riders). Followed with short trip to the Bucky O'Neill VFW 541 in Prescott. Then back to the main highway to head north to Camp Verde to VFW Post 6739. Heard this place is just full of awesome people, and the views, as they sit on top of a hill, look over Camp Verde's valley city area. Two more I can add to my list of visited. Another one of our 'Support' Riders is riding along with me. Have the car pretty much packed up: case of bottled water, trauma kit, 2 boxes of Tees (for the 2 styles we have for sale), my notebook (with all the addresses in case I get lost/lose the group) and a day out of the Valley. Was thinking about stopping in Black Canyon City at Cafe there. It is "world-famous" for their pies. Thought I might stop and get one to bring home, but then I saw the prices online.... almost $30 for a pie. Yeah, they ain't that special to me.

With all that going on, I am sure Sunday will be me resting up, as I have another paracentesis on Monday.

Oh the Joy....
PeacE

For Those That Work .... TGIF!

 Friday has rolled around, and I feel like I got absolutely not one dang thing done. Getting over to the Social Security has been moved to next week (or the attempts to). I just could not get things to work out right for me to get it done this week. I know it is important to get it started forthwith, but still....

Tuesday I did make the VFW House/Entertainment committee meetings and did my secretarial duties. This coming Tuesday, the General Post will vote on the new House Policy that I have helped revamp/emend/revise/update (my first one!) so I am a bit excited. I have been working on this goal for seven months now.

Spent close to an hour up at the Walgreens yesterday. I'm physically out of two of my prescriptions (that have auto-refill) and now have one day left of another. So I go in, as I have not received any of the regular text notifications of auto-refill, or asking if I want a refill. In the past month, the "regular ladies" that work in the pharmacy and I have gotten to know each other a bit. Well, I found out it seems they are all gone (relocates) or retired just all of a sudden it seems. I had three "new" people that didn't know my name, situation, but trying to figure out why their system isn't releasing refills, versus my insurance holding them (which they are). Found out the insurance is 'requiring' a new prior auth for medications (even though some I have been on for years) so my doctor's office has to contact the insurance, then the pharmacy, on each one (I take like 8). I've been out of a couple for a couple days. Already I can feel being chemically "off" a bit.

Friday! This one is a Riders Dinner night for the month. We are serving up some basic spaghetti with sauce, garlic bread, and salad. I believe my friend Stacey even said she was going to bring an easy dessert as well. Even though I am trying to get the Riders Group to "step up" and have others start volunteering (it is slowly working) I try to not offer to help with getting food, or prep, etc. But I did offer finally about Tuesday to get the salad for tonight. Nice and easy, right? Well, tonight will be interesting.... Long story short, we have members that believe that the VFW is "haunted" by spirits - ones they know from the Post. Either way, one of the members knows a popular "medium" and she is doing some private readings tonight, as well as a "show" (I say that, as it sounds like a seance show to me) for a limited number of people as well. Hey, proceeds and the mediums donations, almost all the money for the event comes back to the Post!

Anyhow, I warned our Riders Director, that tonight could be a big dinner night for us, as the "Ghost show" starts a couple hours after our dinner, but people always come up early. He said no it won't. So, typically for the past handful of months, we have averaged around 35-40 dinners in sales. The Director cut it 30-35 tonight. We shall see who was right.

Saturday the Riders also have a Ride! I am planning as of right now to be going, in my 4-wheel Rav4, but it will be a nice ride up to Prescott to a grand opening of a motorcycle place, then to a VFW there in town, then back up north to Camp Verde to visit their VFW, before returning to the Valley. A nice day to get out of town and drive. This will be my first "run", and will be running behind the group, but it is all good. I got the trauma kit and training (hope to not use).

Next week will be interesting. Paracentesis on Monday. Liver Specialist on Wednesday where they will finally get an ultrasound scan of the liver and see what we are working with. May be an adjustment of meds. May be several changes (for the good) but don't know until Wednesday, then I need a day or so to wrap my head around it all.

In the meantime, RM, yes, I will be a the Post for dinner.

PeacE

Monday, January 5

An Optimist Is Never Pleasantly Surprised

 I admit it. I just cannot help myself from getting some of my unfounded hopes to flare to life like something is actually happening. I've talked about the days since I saw the Liver Specialist, and he adjusted a couple of my prescriptions. I have days I wake up feeling actually good, then others that I just roll over and give up. The negative days outweighed the positive ones in the beginning, but now they seem to be evening out somewhat, and that makes me leery of my hope.

I had this year's first scheduled paracentesis this morning. I say scheduled, because I claimed all the Mondays January for this weekly event. Normally in and out after about an hour or so, whereas the ER entry, I'm there for a good 5-7 hours, depending on who the doctor is, and if they even read my chart. So, I have the paracentesis scheduled for 9am. Plenty of rush hour time (hospital is only about 10 minutes away), plenty of time for the valet parking (so I don't have to walk as far - dang construction). At 9am I am still at admitting. I asked if there was a hold-up, so, yes, of course there is. Seems my medical insurance company lists me and the Wife as our policies termed 12/31/25. Wait ... What?!? I just got a confirmation of my appointment yesterday, why hasn't this been checked and approved yet? Wait, termed? I was at a blank (my excuse is it was early and I was at the hospital, trying to figure out what I could do) so the Wife called member services. One of those alleged weird glitches. Seems they printed off our new cards, mailed them to us, have been accepting them at the Doctor's appointments (because terms in 2025), and all without some kind of verification, the correct information was going out. In other words, our new member numbers were not on our cards, so are getting denied now. 

Either way, got the correct member number, and finally sent down to ultrasound. Out before noon. Some background now... last week, during the paracentesis, the tech mentioned something about the needle for the catheter/drain, and how this was a shorter one. It needed to be repositioned, but because it was short, they would have to "re-stick" me to complete it. They had drained 9.1 Liters at that point, so I said, based on previous weeks of there being like 14 L to be drained, to just stop, and we'd get the extra fluid this week (with a longer needle). Today, longer needle, longer time on the table, as we shifted that hospital bed in everyway it was meant to be torqued (that just sounds so sexual). Head up, had down, diagonal all four ways, even had me roll to the side the needle was at for fluid to 'drain that way'. The tech felt confident that we got all the fluid this week around, and the total drained: 10 liters.

Now back to the top... see my hopes? After a week of medicine changes, I started having some better days (feeling like living). After two weeks and a bit, this is the first time the draining has been this low, and my hopes fall that it is just time the medicines needed to get working. This last week has brought on increased urination times and frequency (bonus for losing fluid). Still dealing with nausea at any given time. in public, in private, around food, people with strong cologne/perfume/body smell. Heck, even sitting at the Post, talking to the guys, the smell of the beer off their breath gets me at times. But it has never tempted me to drink. Nothing has as of this time, and I plan on trying to keep it that way.

Still have another paracentesis next Monday, followed by the Liver Specialist appointment on Wednesday. Looking for good news and results. Depending on the frequency of the para's, he may let me back off of them. But for now, another para the following Monday, with a PCP visit as well (to get her up to date). Most after that are Para's (may or not need) and the occasional blood draw (at this time).

Tuesday is going to be fun. I mentioned this whole Disability thing. Tomorrow is when I will drive over to the SSN office to discuss with someone where to get started, etc., and what extra paperwork I need to submit. No idea how long that may last, but I figure a good 1-2 hours (for the first appointment). As I wrap this up, I am trying to get together what medical records I was able to print, and other info they will need (birth cert, etc.,).

PeacE 

Sunday, January 4

Tucking In On A Sunday Night

 Your first Post of the 2026 year.

It is almost bedtime. I feel I have pretty much wasted today, and most of yesterday, and most days of last week. The whole waking up just feeling "off" be it due to meds, or body changes, it just doesn't set well with me to lay around, or sit around (which I cannot do) all day. Makes me feel like I am wasting time I could be doing something important, or needed, or just ... something.

For the month of January, I have appointments each Monday for a paracentesis. Most are 8-9 am, so I don't waste much of the day, and I think one is at 10:30. Either way, with appointments, I am usually in and out within the hour. Last week, 9.1 Liters were drained before we stopped. Something to do with the catheter/needle/device. Nurse stated there was still some fluid i the abdomen, but they would have to re-stick me, and for 3+ liters, I didn't want to go through that again, on the same morning. So, theory and hypothesis would concur that there might be more than 14 Liters in this week's drain. Or, as I sincerely hope, it is actually lower than that (showing that meds/diet/something) is finally working the way it should. Tomorrow will tell....

The Wife woke me this morning, saying she was off to church. I said I didn't feel up to it, and I didn't. Nausea has been hanging around here too long, and I need to kick this to the curb. Wife did bring some Arby's back for lunch, and I was able to eat half, before my taste buds shut down. Between a bite of hamburger, and a curly fry, the taste just left, and I had dry lumps of food to finish. After, I laid down for awhile, but just felt like I was wasting time (like I would anywhere else) so said I was headed up to the Post for a change of scenery (I'm home way too much now). Went there for a couple hours or so, said some hellos, played some games on the tablet, then headed home before 6pm.

Wife was gone, so I kicked into my evening wear (satin pajamas with the red velvet robe) ha! PJ's and a T-shirt... Meetings resume their regular scheduled dates this month with the Post. With the Holidays, and events, meeting cancels, event schedules, house parties, sigh. It's been a month! Anyways, I have everything pretty much set for the House meeting on Tuesday. Riders Dinner on Friday (Spaghetti, garlic bread, salad). Haven't decided about dinner. They need someone to bring salad, so I may wait a day or two to see if any others offer up. Trying to get more people to volunteer in this group.

Went through the bills that showed up this last week. Aside from regular bills, there hasn't been much. Most of my medical was at patient limits by October, and the majority of that is on a "credit card" for the hospital. I did have one bill come in from the ER docs, for that first date of service, I will go ahead and pay. The minimum on the card. Electric bill came, but isn't sue for a couple weeks, but it will go out this week as well. This week will start the accumulation of new medical bills for me. 

First one is tomorrow, for about $371 patient responsibility. Guess what that means? Yup! New spreadsheet!! Since this all started in September, I have gotten somewhat of a chance to learn more of Excel. I had one of the "bibles" I'd bought a few years ago, but the functions, etc. it goes over, is above my head. I need a more basic one for regular arithmetic formulas, text join, splits, etc. Maybe upping my skills will up my getting a job game.

The end of December I made the move to claim Disability. I've been told there is a difference between SS Disability, and just Disability. The one D gets less money. not worried, it's to supplement costs with all the medical. I determined through the online process, there was no way for me to submit an application, even with my 500Mb (exaggerated) of medical, birth cert, etc. So at some point this week I need to go to a SSN office and meet with someone that can direct me to where I need to go for assistance. Luckily, there are two offices within 10 miles of the house. I think we will pencil that in for Tuesday. I got to go look if I have to call for an appointment or just show up....

With that all said, I'm getting off of here. I know RM has been hinting I haven't been updating here (or anywhere) but no sense if there is no new info to share. Everyone knows I feel nauseous some days, better some others, and know to just leave me alone.

PeacE