The effect of stress on health

by WCE

This article on stress levels and cholesterol made me think. How much does avoiding stress affect your work/life choices? I’m curious about whether control affects the perception of stress. When I have a lot going on, but I have control over it, I am less stressed than when I am subject to someone else’s arbitrary schedule or needs. I think my Dad and MIL, who each cared for a terminally ill spouse, were affected as caregivers in ways that affected their long-term health.

Why do you think there is so much research on diet/exercise and so little research on stress?

Stress Raises Cholesterol More Than You Think

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98 thoughts on “The effect of stress on health

  1. “Why do you think there is so much research on diet/exercise and so little research on stress?”

    Because the past 50 years of medical research has centered on the concept that you are what you eat — and even more specifically, that the specific amounts of a particular substance you ingest will lead to higher levels of that same substance within your body. It’s the same reason we ended up with Snackwells to combat heart disease and obesity. I would argue the entire scientific community had groupthink, and even those willing to question conventional wisdom could not get funding to test alternate hypotheses.

    OTOH, I did find this pretty funny: “he counsels patients to find ways to lower their stress, such as carving out 20 minutes for a workout on a home bike or treadmill.” There have been times in my life when trying to carve out 20 minutes for one. more. thing. would have *added* to my stress.

  2. I can’t read the story as I am not a subscriber.

    I have felt a lot of stress since the end of May 2015 when my dad was hospitalized and then passed away. While I knew I would be playing a major role in settling my dad’s estate and there would be an uptick in the amount of caregiving I would need to provide for my mom, I never expected it to be at this level so fast.

    I believe that the less control you have or perceive that you have the more you feel the stress. I have been in higher overall stress situations, but did not feel it as much because I had more control. I have been told many times, let someone else help or pay for services. Sometimes that is easy and sometimes it isn’t as the amount of work to get things set up and monitoring them (seems at least) is as much work as just doing it. I’ve also been told to shed things from my plate. However, many of those things, while an obligation, are a distration from the caregiving or are relaxing or allow you to interact with other people where the main focus is not the stressful situation.

    Another element is choice…did you choose this situation. For example, my daughter is feeling less stress at school even though she is taking the same or harder workload than some of her friends. After a long discussion this weekend, one of the things she concluded was that this high school and the level of classes she is taking was her choice. I’ve advocated for dialing back a bit, but she doesn’t want to. So even though she is seeing the pile on of work that happens right before the end of the grading period, her attitude has been more of, yep its coming, time to ramp up and suck it up. Many of her friends are at the school because their parents decided with little input from the child and seem much more stressed.

    About its affects on health – I’ve been trying to lose some weight I gained upon retiring…less built in exercise (no 1/2 mile to from parking to building for example), easier access to food, and I do tend to stress-eat. I was making fairly steady, though slow progress, and have lost about 10 pounds, but am now stuck. Then my stress levels went up higher and though I am following my plan, I think it is the stress levels that are now making it hard, even though my stress-eating is way down. I have about 15 pounds to go.

  3. My current job is can be fairly stressful, but I’ve slowly learned to manage the stress. I give myself permission to only do what I can do.

  4. The assumption, at least in the US, is that stress is mostly a life condition and not freely chosen, but good diet and exercise are not only witin our control, but also virtuous activities that *will* lead to better health outcomes. So the constant research to determine exactly which regimens are most effective for various conditions.

    Modern research on diet and cholesterol has mostly led to the conclusion that short of a low gycemic plant based diet, changes in the composition of a diet have little effect on serum cholesterol. Much of high cholesterol is genetic in origin. The real question is whether agressive drug treatment of borderline high LDL for 40 plus years is necessary. It is not a fight I feel I need to have with my doctor, so I acquiesced.

  5. Even without a subscription, you should be able to access the article if you Google the title.

    Choice is big, big, big for me in being able to manage stress. It’s often unclear to me if others choose their stressful lives consciously. I see people who seem to be unhappily stressed yet they continue to make choices that seem to add more chaos to their lives. I don’t know. Maybe an uneventful life would be boring and stress them more.

  6. The assumption, at least in the US, is that stress is mostly a life condition and not freely chosen, but good diet and exercise are not only witin our control, but also virtuous activities that *will* lead to better health outcomes. So the constant research to determine exactly which regimens

    Right. Plus it’s harder to quantify stress, which makes it harder to research its effects.

  7. I don’t need a zillion dollar government study to know that stress makes me physically ill. I can feel it because I can’t sleep, my eye twitches, my fingernails get brittle, and I grind my teeth. Sometimes my stomach hurts too. These are just the VISIBLE signs, so I am sure that I am damaging my insides from stress.

    I tried to reduce my stress level when I left my full time job, but I am really finding this sandwich generation thing to be more stressful than any job that I ever had that caused stress. The reason is that I was being paid for the stress, and I always knew that I could walk away eventually.

    There is no escape from the elder care thing. It started with my mother’s boyfriend four years ago, then my mom, my FIL, my mom, and now this stuff with my FIL and his wife. It’s crazy stressful because it is hard to make plans for anything. It disrupts daily patterns for work and school, and we aren’t even making any vacation plans for this year. Any vacation will have to be last minute.

  8. ^ Or maybe they believe they don’t really have choices. They feel they have to do certain things because of family obligations or guilt or other reasons.

  9. Even without a subscription, you should be able to access the article if you Google the title.

    They seem to have closed that backdoor.

  10. This gets back to the discussion of exercise a few days ago. If I run, my perception of stress is much lower. I can have 2 nearly identical weeks with lots of stress factors, but the week that I run at least 4 times feels much more manageable than the week that I don’t get in the run. This is why even when work is insane or I’m traveling or kids or sick I try my best to prioritize the run.

  11. My husband and I suffered high stress for over a decade. I do think it had an effect on our health. I do think my husband suffered more – though our stress is normal, everyday stress now, his stress is out of proportion to the situation. I don’t know if he isn’t able to get off the high stress mark or if he feels stress more keenly than most. It is hard sometimes to hear him out about all the stress in his life without telling him to knock it off and count his blessings. I know the stress is very real to him so I try not to get snippy.

  12. For me- and for many of you- it seems that accepting stress, especially caregiver stress, is part of being a responsible, capable adult. I would classify “money” as my greatest stress reducer, because it gives me choices that I would not have without it. However, I have enough money that having more would not reduce my stress more, i.e. I have largely hit the threshold benefit for “money”. Probably the next stress reducer is lowering my standards and taking advantage of short-term fixes, like working from home for part of today while a couple boys are sick.

    The rest of my current stress is work-family balance, and that will get easier when Mr WCE stops traveling so much and my children are old enough that I can stay for a meeting without having arranged childcare in advance.

  13. Like Lauren, I have, at different times in my life, developed a physiological reaction to stress–eye tic/blinking. It was most pronounced around the start of Kindergarten, as well as the first half of freshman year of college, with a few more minor appearances in between. I think that I finally figured out how I was going to deal with it in college, and if the result is that I take a more cavalier attitude about potential stressors than many would find appropriate, I’m OK with that.

  14. I was surprised to find my mother on pills for cholesterol and hypertension. She attributed the issues to her job but now she is retired so I have been suggesting less dependence on pills and more aggressive management. My BIL has been on cholesterol lowering drug for the last few years. I honestly think his doctor didn’t give him time or a chance to change his lifestyle and now even though he eats healthy and excercises, he is still on medication. I feel medication was prescribed all too soon in both cases.

  15. give him time or a chance to change his lifestyle

    People don’t change. Maybe after a heart attack or stroke they might, just might change a little. But, the number of people who change before that is basically zero.

  16. Louise – the doctors have charts and the benchmarks keep being adjusted lower and lower and at earlier and earlier ages. I insisted after losing 30 pounds that I go off both blood pressure and cholesterol medicine, the only pills other than Zyrtec I was prescribed. BP has been terrific. My doctor sent me to the nutritionist and I dutifully followed her advice for six months. My LDL went through the roof. A little googling showed that Fish Oil does that for people whose high LDL is genetic in origin. At that point we made a deal. I’ll take the mildest dose of the mildest statin until I lose another 15 pounds, and we’ll try again. It is likely that nothing, not diet and exercise, will move my baseline LDL into their happy range (my ratios have always been fine even as an older woman). At that point I may just refuse the medication, but it will probably be three years before the test given my usual very gradual weight loss success.

  17. I think that diet, sleep, avoiding chronic stress and exercise are all important to your health and you need to be taking care of all four to feel really good and healthy. I get stressed out about silly things but stress gets magnified if I’m not eating right, exercising and sleeping well. Overall I’m a pretty laid back person (or I’ve trained myself to be) but DH is the opposite. He gets super busy at work and then his sleep goes. He’ll wake up at like 5:30 a.m. after having gone to bed at midnight or later and just cannot fall back to sleep. I think his personality is just more sensitive in that way.

  18. For people who are already reasonably healthy, how effective is diet/exercise? Most of the success stories I read about are of people with a BMI > 30 or a cigarette habit to start. My family trait is vulnerability to diabetes, and we stay “pre-diabetic” forever because we make reasonably healthy choices but are genetically vulnerable. Is cholesterol similar?

  19. I still think stress contributed to my early delivery of #1 child. We also had a super-stressful 6 months in last quarter 2011 and first quarter 2012 – DH took 2 online Stanford classes, also stopped one job and started another and had to negotiate his separation and contract with the first company for revenue-sharing, I was pregnant, we were fixing up the master bath and breakfast room, and we refinanced at the same time. We had outflows equal to my annual income in Q1 2012. I really noticed it in DH because his hair started falling out in patches – mostly in his face/beard but also a couple random places on the back of his head. Luckily, since then things haven’t been that bad! :) We do feel the uncertainty of moving/not moving weighing heavily on us these days, though. I will be glad if/when we can sell the house!!!

  20. I thought the research on statins was that they really only help in about 10% of cases and shouldn’t be widely prescribed.

  21. I thought the research on statins was that they really only help in about 10% of cases and shouldn’t be widely prescribed.

    Other way around – diet can only affect cholesterol by about 10%. Most cardiologists I know – truly an evidence based group if there ever was one – think statins are our generation’s wonder drug.

  22. By the way, FASCINATING article out of Duke today about their efforts to develop a screen for whether an infection is viral or bacterial. That would be a tremendous breakthrough in health care services.

  23. Milo, I have found myself in the weird, non-Totebaggy position of trying to teach my son to take a more cavalier attitude about things. I never thought I’d be on that side of the conversation.

  24. I haven’t been offered statins, so I glanced quickly at news, but I thought the recent understanding was that statins were turning out to be particularly bad for women, who were responding to the medications differently than men?

    WCE– I have a friend who regularly says, “It isn’t a problem if I can afford to throw money at it.” It’s a bat cavalier, but I get it. A lot of things that I remember being very, very stressful growing up just aren’t anymore, like paying for groceries. There’s also the interesting phenomenon that I can afford to think about my kids’ social circle issues because I don’t have to worry about how to feed her. I suspect some of us are wired to be more stressed out than others, and find an issue to worry about that matches our life circumstances.

    I still stress out, but I’ve worked hard on letting a lot of that stuff go. Often I’ll ask the “what’s the worst outcome possible?” question, which is ludicrously unlikely, and that’s enough to get me out of the spiral of worry. I also picked up a short meditation habit last summer that I find feels useless in the minute, but over the last months has made an overall difference in how I experience stressful moments.

  25. Stress has definitely increased for me in 2016 due to work. I like my job but the volume of work has increased significantly – so even though I’m working hard, I’m can never catch up. My colleagues are in the same position. Haven’t decided what I’m going to do about this yet as I genuinely like my job and my colleagues. But it’s certainly leading to me being crankier at home – and managing my stress with carbs (which has led to a 5 pound weight gain).

  26. WCE – The answer to your question is not exactly. People with a family tendency to diabetes and early prediabetic levels can delay or even prevent the onset of diabetes by weight and dietary management. The degree to which a 24 BMI rather than a 29 BMI or a fish-veg low glycemic diet versus a balanced omnivorous diet is required to achieve that is very individual. Familial high LDL is found in thin active vegetarian 18 year olds. In that case, the question is more whether it is advisable to administer 70 years of statins to prevent the gradual build up of fatty deposits, or whether treatment should begin in their forties or when an additional serious risk factor is identified. The answer obviously depends on degree, the ratios, and gender.

  27. “Familial high LDL is found in thin active vegetarian 18 year olds. In that case, the question is more whether it is advisable to administer 70 years of statins to prevent the gradual build up of fatty deposits, or whether treatment should begin in their forties or when an additional serious risk factor is identified. The answer obviously depends on degree, the ratios, and gender.”

    I know someone who follows an extremely healthy lifestyle yet suffers from high cholesterol, which runs in the family On top of that, she suffers side effects from statins meds. She’s gone back and forth with her doctors on how or if she should be treated. No right answer I suppose.

  28. Within a two-week period last year, the guy training me for my new job, a guy in my husband’s carpool, and my BIL all had heart attacks. No member of my husband’s immediate family has made it to 60 without having both a stroke and a heart attack. We now take this very seriously. I build time into my schedule to de-stress. One of the reasons I picked the neighborhood I am in is because I like walking with a nature view (but could pass on the alligators!) I try to limit the amount of rushing around we do on week nights, and I am trying to not work at all several evenings per week. I still resort to takeout when I am stressed sometimes, but with advice from some of you I have some easy go-to dinners so we do that much less frequently. Sleep plays a huge role in how I manage stress so I fight my natural inclination to stay up late reading. I have a personality type where I thrive on a certain amount of stress, but I can see the detrimental effects on my health. I was just in denial about it until the rash of heart attacks last summer.

    Because both my kids manage stress somewhat poorly, I talk to both about structuring their lives in such a way as not to create more stress.

  29. “People don’t change”

    I’ve known quite a few who have, mainly totebaggy types. I myself have changed lifestyle habits to follow doctor’s orders, but then if it turns out not to make much of a difference I’ll revert back to doing what I want. :) When I was a teen I was told to cut out chocolate to get rid of acne, for example. Although I LOVE chocolate, I followed orders religiously. But it didn’t make a dime’s worth of difference. Antibiotics worked much better.

  30. “People don’t change”

    Dh’s dad had a heart attack about 5 years ago, since then he’s put on about 25 pounds and continued to smoke. We went to visit him a few weeks ago and his sister was talking about how bad his knee is getting and how he really needs to retire (he works part time and collects SS). I’m thinking that is the last thing he needs – more time to sit around the house not exercising and smoking.

  31. There are piles of articles on stress and health. I see one almost every day. They make me feel guilty because I can’t really control the amount of stress that comes at me.

  32. There is a steady drumbeat of articles telling me that if I don’t sleep more, exercise more, brush my teeth more, connect with people more, diet more, and meditate more, I will destroy my health. Sorry, but if I exercise more, I will have to sleep less. If I take time to meditate (ick!), I will have to cut back on connecting with people. . All these articles add to my stress so I try not to notice them

  33. I retired when people still wanted to overpay me because I wanted to have quality time with my husband, especially to travel. When my grandkids moved nearby I won the retirement lottery, so I thought. The ability to sleep in as needed, to say mañana about almost anything on the to do list, those two items eliminated most of the daily stress. Of course, in the next year there were two major family health crises, but the underlying reduction in the daily stress “nut” paid off. Calibrating how volunteer responsibilities add to that nut and enjoyable pastimes and physical activity reduce it is part of the ongoing stress management agenda. Keeping an orderly house is facilitated by some purging and reorganization and the biweekly cleaner. Managing my husband’s considerable health needs is made more enjoyable by integrating adventurous cooking and new less physical forms of travel into the mix. Updating my legal paperwork (almost done) to cover most eventualities reduces the amount of time spent worrying about what ifs.

  34. The diabetes-prone side of my family gets internal cancer in their 80’s and dies. I definitely prefer that to my alternative on the other side, getting combative dementia and staying alive to 95+.

    Cardiologists are highly biased toward seeing the benefits of statins (fewer/less severe heart attacks) and ignoring the muscle aches/organ function issues that are often side effects of statins, especially statins taken for several decades. Cardiologists also probably don’t think much about all the people who take statins whom they don’t see, nor do they spend much mental effort comparing the statin-takers they don’t see to the non-statin-takers they don’t see.

    I suspect cardiologists are data driven but more motivated to look at data for problems they are paid to treat.

  35. “I have enough money that having more would not reduce my stress more”

    I am very skeptical of this.

    E.g., wouldn’t your stress levels go down if you had enough money that you didn’t have to work? How about if you had enough money that Mr. WCE could take a job that didn’t require so much travel, even if it was at a significantly lower salary?

    Or more generally, how about if you had enough money that you, and Mr. WCE, did not have to work?

    I’ve talked to a number of people who worked for a while after reaching eligibility for retirement with the financial resource to retire comfortably at that point. A common sentiment was that work became more enjoyable and less stressful knowing that at any time they could just walk away.

  36. “There is a steady drumbeat of articles telling me that if I don’t sleep more, exercise more, brush my teeth more, connect with people more, diet more, and meditate more, I will destroy my health.”

    One way to do more of these is to find ways to do more than one of these at the same time.

    E.g., it is possible to connect with people and exercise at the same time.

    Perhaps it’s possible to meditate and exercise simultaneously, or at least get some of the benefits of meditation. I find that a long bike ride can clear my mind. Resistance workouts can also force me to clear my mind as I focus on form and counting reps.

  37. @WCE – agreed. I read Grain Brain over the holiday. A lot of the science in there is pretty squishy, but I found some of the connections between statins and dementia concerning.

    The best models of heart disease we have emphasize hormones (insulin, cortisol, serotonin) over cholesterol (this is changed in the last 20 years.) I worry more about soda as a risk than bacon.

    I find that people tend to blame stress for nearly all acute medical pathology – both deserved and otherwise. Appendicitis and panic attacks. Strokes and cancer. The thing is most people have a lot of stressful things in their lives. Some people have lots and lots of stress. You can’t influence a loved ones illness, a job loss, etc. but you can influence your reaction.

  38. Finn, certainly if I had a LOT more money, I would have less stress. But I’m working now largely to keep my foot in the door and because I didn’t do as well emotionally when I was a SAHP for five years. I enjoying interacting with other engineers more than I do with other SAHM’s. I also want to stay employable because we aren’t financially ready for retirement yet.

    Mr WCE doesn’t seem to want to take a lower stress job, and there is a fairly clear end (every 4 year printing demo in a European country this Memorial Day) to the current schedule issues. In a world where he could find a job he liked and share housework/childcare more equally, I would probably be less stressed, but that isn’t the current world. Having a fourth child also wasn’t the world’s best stress-reduction decision.

  39. Having a fourth child also wasn’t the world’s best stress-reduction decision.

    Just wait…having a daughter is pretty cool when they can talk like human beings.

  40. super stressed out right now, my short term disability paperwork is screwed up and it takes days to get anyone to call you back

  41. I transferred to civilian employment right when the financial crisis was in full panic mode, and it was the first time in my life that I was in a position where I potentially might never find a job, or get laid off from one, and I was responsible for keeping other people fed and sheltered. This hit when every other news story was about a new Depression and people who were going to be permanently out of work. I was able to rationalize away a lot of the stress then, but it was stress that hadn’t even been there before. It also made me a *lot* more susceptible to the MMM philosophy, although back in those days it was GRS.

    Now there’s not much stress because even though I wouldn’t yet be comfortable retiring like Finn’s coworkers, as long as I work full-time at something, and it could be just about anything, we’ll be fine. I may still need a job, but I certainly don’t need THIS job.

  42. I find that I have stress by choice (continue to work part time after retirement; volunteering for organizations/kids activities) and stress force upon me (elderly parent caregiving) feel different. Those by choice are more controllable or at least are regularly/routinely scheduled. Those forced upon my are not (unpredictable trips to the ER or entry/discharge to rehab facilities).

    Granted there is some stress forced upon me even in those stress by choice areas – work has a deadline that I didn’t have any input in or a volunteer job that looked like a 5 hour committment morphed into a 10 hour committment. However, I can always quit them. When you are the MPOA, it is not something you can walk away from in the same way.

  43. I bet that’s medical power of attorney and not multi-protocol over ATM… as I troubleshoot my network issues with IT…

  44. “I enjoying interacting with other engineers more than I do with other SAHM’s.”

    Of course. That’s totally understandable, and that interaction probably helps reduce your stress levels.

  45. WCE,

    Would you enjoy interacting with other engineers who are currently SAHM’s?
    As former/retired attorney who enjoys interacting with other attorneys (really), I found it much easier to be a SAHM in the DC area than in our current community. I’ve met a few younger moms who are the spouses of graduate students or new faculty but not themselves either former or future professionals and though they are delightful women it’s kind of hard to relate to them, even taking into account the age difference.

  46. “One way to do more of these is to find ways to do more than one of these at the same time.”

    I combine my 3 am insomnia with meditation. Joking. Kind of.

  47. “As former/retired attorney who enjoys interacting with other attorneys (really), I found it much easier to be a SAHM in the DC area than in our current community. I’ve met a few younger moms who are the spouses of graduate students or new faculty but not themselves either former or future professionals and though they are delightful women it’s kind of hard to relate to them, even taking into account the age difference.”

    It is difficult to find other women who were once professionals. I like interacting with attorneys, even though I am not one. Professionally, engineers always thought so differently. The running jokes was that the engineering asked how do we built this? The lawyers asked are we obliged to build this? The economists asked, is this a good idea? And no one thought the other’s questions were of much import.

  48. Scarlett, I would enjoy interacting with other engineers who are SAHM, and my favorite women are those with engineering/technical backgrounds who have managed or are managing the work/family balance. There is one woman locally who attended the same math camp I did who is a childless medical specialist. Her leisure activities (travel, wine tasting) and schedule (work long hours with weekends off) are so different from mine that we wouldn’t fall into friendship. I’m hoping to form a friendship with an engineering professor wife who works part-time advising international grad students.

    Another aspect of my SAHM years was that I was managing three children in an age range where most people had one child or at most two. Some people at the library assumed I was a daycare provider. There are few transplants around here and the advent of smartphones (big rise between DS and Baby WCE) means that people can interact with their existing friends, not have to find new ones, even when they are out and about.

  49. For me the women I make friends with are the “more enthusiastic about something” people. Now that my kids are older I find SAHMs doing part time jobs that keep them occupied but are not typical professional jobs. So, one is a photographer, some else sells medical insurance etc. The women lawyers in my neighborhood work full time and their spouses work from home or are SAHPs. One more is a qualified lawyer but I don’t think she worked much. It is interesting to see the changes as the kids get older.

  50. “Some people at the library assumed I was a daycare provider. ”

    Weren’t you?

  51. Finn, yes, but I was also the night ‘n’ weekend care provider. It can be hard for nannies/childcare providers and moms to form friendships.

    BTW, my throughput strategy is sufficiently good that we might pull a shift back at a SE Asia site. I wanted you to know. :)

  52. Does anyone have experience choosing between Medicare A & B and Advantage HMO or PPO?

    Enrollee needs a plan with no premium which will pay for cataract surgery (and should qualify as a QMB, so I’m looking for something with no out of pocket costs).

  53. “Speaking of which, are you AP graded?
    ‘Cause these days you look a bit heavily-weighted”.

    JAP Rap battle from Crazy Ex-Girlfriend. I kind of love/hate that show.

  54. I just got a call from my kid’s school that an aide has been arrested for inappropriate conduct with a minor. My stress just went up a bit.

  55. WCE, do you get regular blood tests because of your work environment?

    For much of my 20s and 30s, my job involved potential exposure to a lot of chemicals, so I was required to have annual blood tests. Those blood tests also showed things like blood sugar and cholesterol levels. Based on the medical standards of the times, my levels were not high enough to raise any alarms.

    But over time, the benchmarks moved down. While my levels staying pretty consistent, those levels were now high enough to raise alarms and now require regular monitoring.

    I’ve tried to change my diet and exercise routines, but those have had minimal impact on my blood test results, consistent with Lark’s point. I’ve not seen any swings that I could attribute to stress either.

    It seems that the two things that could really affect my cholesterol levels are genetics and medication.

  56. No blood tests. I have similar trends, but nothing that makes me think that Gompertz Law of Human Mortality isn’t the dominant law of human death and decline

  57. Here I have no trouble forming casual friendships with the second career nannies (former SAHMs whose kids are grown) but the ones in their 20s and 30s are hit and miss because a fair number aren’t fluent in English.

    Most of the SAHMs here are former professionals, because few other people can afford homes here.

    WCE, there are a lot of new Maker clubs for kids here – maybe your kids could join or start one, which would help your odds of meeting similar moms.

  58. Sky, thanks for the suggestion. If my work schedule allowed and we were closer to the Maker Club (it’s 10 miles away at the library, and I’d have the twins and Baby WCE to manage during the meetings) and we weren’t the last bus stop in our two local cities (meaning the Club starts before our bus comes), I might pursue it. Maybe in a couple years…

  59. Sky – Medicare Advantage plans are all offered and priced locally. Most are HMO style, so dual residence people don’t use them. I will be enrolling in 6 mos, so I have done my local homework and am opting for a cheap plan with no additional premium over Medicare Part B and Part D if I decide to get drug coverage (jury is still out on that one). For all plans Max out of pocket per year is 3400. Zero dollar plan – outpatient surgery is 250. Specialist visit is 40 per. 96 dollars a month gets you 125 for outpatient surgery and 20 dollars per visit. I can do the math.

  60. Thanks, Meme. After a few hours of research it looks like the person I’m helping is dual eligible (Medicare/Medicaid) which means there is a very short list of HMOs to choose among in that state.

  61. Sky – I was going to ask that next. Dual eligible people don’t have to pay out of pocket, but the choices are limited. She has to apply, of course, and prove that she meets the asset limits for the Medicaid portion.

  62. WCE,
    Have you given much thought to an after-school nanny? We converted from full-time Montessori daycare to a nanny when my boys turned 1 and 3. Now, I was full time and the kids were young, so daycare was already a big spend. However, it’s such a life changer that I continue to share it as a work-life balance choice with younger moms.

    We kept that nanny until the youngest was in first grade, then converted to after-school nannies for a few years – one college kid (jr college students seemed to be more attracted to this type of position) and one retired woman. By that point, much of the duty was ferrying to sports practices and other activities – which included library and park visits. In your case, I’m thinking it would give you an extra person to be home when the bus comes so you can get to maker camp, or to help pick kiddos up from conflicting activities – which are bound to be a regular occurence with four children.

    This is yet another way that a comfortable financial situation can help mitigate stress.

  63. Sunshine, that’s a good idea. I’ll have to think on it. While the financial inflow/outflow now is OK, work is going through another round of layoffs and Mr WCE’s group is the only one hiring, so he’s overloaded and stressed. I’ve been ready to consider moving for awhile, and he isn’t/doesn’t like to plan and strategize in that way. Not sure what will happen, but the issues (overseas competitors don’t have our wage/benefits costs or environmental costs) won’t be going away.

  64. So I caucused last night. Second time for me. I kind of hate it because I have to be awake and dressed and wearing shoes at 7pm, which is onerous. But since I love America, I sucked it up. The high school was so vastly overstuffed with humanity that it must surely have been a violation of the fire code. It was roasting hot. It’s fun to see your neighbors and chat, and it feels sort of old-timey and participatory. But if Colorado would like to just go to a damn primary system with mail-in ballots, I’m okay with that.

    Oh, and I forgot where my car was parked and a very nice lady gave me a ride around the neighborhood til we found it. Angry feminists can be so helpful.

  65. I definitely feel like stress contributes to my inability to sleep as well as I should. It also contributes to me being less productive at work than I should be (well that and this place, you bad influences).

    Some I am trying to let go.

    And it’s not as if I lack exercise.

  66. “I kind of hate it because I have to be awake and dressed and wearing shoes at 7pm, which is onerous. But since I love America, I sucked it up.”

    Ah, Rocky, I love you. :-)

  67. Ada may be along shortly to beat me up, but my husband’s doctor (a real MD, but with “integrative” tendencies) suggested Jarrow Formulas Gaba Soothe to help with sleep, and IMO it works pretty well. Of course it could be placebo effect.

  68. I voted for Kasich, DW for Rubio.

    We were talking about the possibility of President Trump last night, and I was a little depressed at the options, but then he came on TV and did a press conference instead of a victory speech. The thing is, he was very good. Tired, but very charismatic and personable. He’s also subtly dialing back his more extreme positions; when a reporter asked about the Muslim immigratio
    n comments, he would only say “We just have to figure out what’s going on.”

    This morning I’m seeing conservative articles that are no longer afraid of any extremism, but rather that he’d be too compromising and collaborative with Congressional Democrats.

  69. I discovered that as unaffiliated I can create trouble by voting in party primaries. My state has a semi-open primary. I had to request a ballot which had to get done in Feb – so no chance of me voting now. The typical lazy voter.

  70. Munch munch munch.

    Nah… I like chamomile and melatonin – randomized controlled trials that back them up and few side effects.

  71. “I kind of hate it because I have to be awake and dressed and wearing shoes at 7pm, which is onerous. But since I love America, I sucked it up.”

    Ah, Rocky, I love you. :-)

    +1

    Best stress relief for me – laughing. Watching stand-up, reading Hitchhiker, goofing around with the kids – anything to make me laugh and re-gain some perspective.

    Best part about the Oscars was the stand-up comic presenters.

    I should probably buy Tina Fey’s books – love her.

  72. “why Kasich over Rubio?”

    I’ve liked him the most all along. More experienced, seems like a better personality to be an effective leader.

    If I’d known how poorly he’d do yesterday, I probably would have voted for Rubio in order to coalesce.

    But I’m really thinking it’s going to be Trump as the nominee, and with the help of the FBI, the 45th President. I couldn’t believe how well he came across last night. If you give him nothing else, the man is a very good speaker.

  73. Watching what my mom is going through, I can only say be careful about not getting Part D. They decided against it because they didn’t take much medication, which is true for people their age, but some of it is pricey. One med is $100/mo for 1 pill.

    For me the worst part was, after one of Mom’s hospital stays (my dad was still alive, but unwilling) I had to be trainined to give her IV antibiotics for 10 days – thankfully short term and only 1 time per day. However, if she’d had Part D, it would have covered the nurse to come give it to her.

    I’m lucky in that my retiree health insurance becomes my Part B and D when I hit 65. So, not so many choices and its paid for as part of my retiree benefits.

  74. Honestly, I usually buy what’s on sale. Also, I prefer gummi melatonin. It’s more “family friendly”. (Though I really don’t understand why they write “for adult use only” on the package, why else would it be a gummy?)

  75. I think a caucus might have been interesting to participate in once or twice. But I’ll take early voting on my lunch break with no line any day.

    I tend to agree with the Slate article. Basic statistics and numeracy could be much more worthwhile to a large group of students than pre-calculus and calculus. I was just talking to my husband yesterday about how neither of us remembers a lick of pre-calc or calc because we have never used it since we took the classes over 20 years ago. (In my case, I did use it when studying Economics in college, but I used statistics much more. And again – 20 years ago.) I did fine in calculus, I just don’t remember any of it, just like I don’t remember how to speak French even though I was once near-fluent.

  76. “This morning I’m seeing conservative articles that are no longer afraid of any extremism, but rather that he’d be too compromising and collaborative with Congressional Democrats.”

    It’s depressing, but likely accurate, that voters fear collaboration more than extremism.

  77. “This morning I’m seeing conservative articles that are no longer afraid of any extremism, but rather that he’d be too compromising and collaborative with Congressional Democrats.”

    Do you think that’s in an effort to convince Democratic-leaning Anti-Hillary voters to vote for him because he’s “not that bad”?

  78. that voters fear collaboration more than extremism.

    Trumps victory proves the opposite, I think.

  79. “Do you think that’s in an effort to convince Democratic-leaning Anti-Hillary voters to vote for him because he’s “not that bad”?”

    No. It’s not that sophisticated, and they really just don’t like him.

    Rhett – I agree. It’s the “Establishment” only. But, as we’ve seen, and Trump pointed out last night, he’s bringing new people into the tent, many of whom probably didn’t participate before. The enthusiasm gap between D and R is huge right now. Republican primaries are blowing away previous records set in 2000; Dems are well under 2008 levels.

  80. Republican primaries are blowing away previous records set in 2000; Dems are well under 2008 levels.

    The dems already have their nominee why would you expect high turnout?

  81. “The dems already have their nominee why would you expect high turnout?”

    That’s not exactly true, and less so before last night, and it definitely wasn’t true in IA, NH, and NV, but the disparity was consistent throughout.

  82. “The dems already have their nominee why would you expect high turnout?”

    Right – at this time in 2008, there was a highly contested and emotional battle going on between Hillary and Obama. Bernie isn’t really a contender anymore. I haven’t looked, but I think I remember that 2008 for the Dems was breaking turnout records. I might not have even bothered to vote in my state primary if there weren’t important races lower on the ballot. And how many people care about their state senator, county clerk or judges? (We also have a US senate seat up for grabs, but I don’t think that the primary is very close.)

  83. “The dems already have their nominee why would you expect high turnout?”

    true, people did’t expect Bernie to carry 4 states

  84. I am glad he gave more information on the wall! 50 feet high (though he’ll compromise on a few feet!), 1-2k ft long. Won’t be a problem since the Great Wall is 13k ft long. Plus we’ll have Mexico paying for ours.

    What was Christie doing up there? What does he bring to the table? I thought everyone hated him now?

  85. Cat – he was interviewed by Hannity the night before and he was telling his story about some really arrogant thing Vincente Fox had said to him, and Trump re-tells it dramatically: “You know what I said after that? The Wall just got 10 feet higher.”

    A half-century from now, political science professors will be lecturing about the campaign brilliance of The Wall as digestible metaphor.

    Christie looked like a tired bodyguard up there. Trump was flanked on the other side by his son (I think), but the camera angle only captured Christie, which made him look even more like loyal lap-dog.

  86. “no longer afraid of any extremism, but rather that he’d be too compromising and collaborative with Congressional Democrats.”

    I can see that, Trump prioritizing The Deal above party principals.

    That could be very good for the country, especially if he ends up picking the replacement for Scalia.

  87. Do you think it is possible that Christie is going to be his VP? I just can’t figure out what is going on! He (Christie) looked like he didn’t quite trust whatever deal he had cut with Trump.

    I loved Trump’s speech last night. My husband (who also votes for Kasich) and I were laughing so hard. He talked for 45 minutes and said nothing at all. Someone in the audience called him on it, and he told them he answered the question. No! No you didn’t! You never say anything of substance (other than about The Wall).

  88. Yeah, I could not stop laughing out loud. I can’t even begin to guess who his running mate would be. Normal it’s decided before the convention, so it will depend if the party is still talking about challenging him.

    I don’t think his talk was any less substantive than typical candidates’. It was just better. Cruz, immediately following him, was absolutely terrible.

  89. Ada – I only use gummy supplements. I have a terrible nauseous reaction to a binder used in typical multivitamins and other supplements.

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