Issue link: https://www.epageflip.net/i/133142
Wednesday, May 29, 2013 – Daily News 3B FEATURES Loveless marriage leaves man lonely Treatments for sleep apnea offer comfort pain. I am looking Dear Annie: My at a bottle of pills, wife and I have been wondering whether married for 34 I should take them years. I changed and simply get out jobs so I could have of her way. — better hours and pay Rejected and more time with Dear Rejected: my wife and son. Please don't. Your Eighteen months ago, I went on dis- Annie's wife isn't looking to divorce. The ability due to severe main problem is arthritis. A few years by Kathy Mitchell that she's no longer back, I noticed that and Marcy Sugar interested in sex. She believes (and my wife was coming up with reasons for us perhaps rightly) that being not to have sex. She said my around you means she will work hours kept her up too feel pressured to be intilate, and then she played mate. So she avoids you by Internet games all night. A spending time online or year ago, her father died, with Mom. The two of you have and she claims she has to stay with Mom five nights a decisions to make. Is she week. In the past eight willing to have sex on occamonths, we've had sex sion? Are you willing to live without it? Are there other twice. I never forget an occa- accommodations you could sion and bought her lovely reach regarding intimacy? gifts for Valentine's Day, her Please discuss these issues birthday and our anniver- honestly and openly. If you sary. She got me nothing. find it too difficult to start She could have asked her this conversation, talk to brother to stay with Mom, your doctor about a referral but didn't. I spent my birth- to a marriage counselor. Dear Annie: My dad is day alone, without even a phone call. I spent our getting remarried on Labor anniversary watching her Day weekend. Though I'm play Internet games, and happy for him, this will be when we finally got into his third marriage. I went to bed, she pushed me away, the last two ceremonies. telling me to leave her alone. During his most recent marWe had a big argument, and riage, he put his new famishe said she doesn't love me ly's needs ahead of those of and only stays because of my siblings and me from the our 30-year-old son. She ''old marriage.'' I'm expectalso said I need her because ing the same this time around. of her insurance. Here's the problem: I Annie, I am afraid I am going to die alone and in have been training for Mailbox months to run a full marathon that happens to be scheduled the same day as the wedding. I didn't know about the wedding until after I'd already signed up for the marathon. Although I'd be finished running by the time the ceremony begins, it's three hours away and a long drive after a physically and emotionally intense event. My dad says it's really important to him that I go, and so do my siblings. But I'm turning 30 soon and am weary of Dad's immaturity. Should I go to both events? Should I put my needs first and not go at all? - LongDistance Runner Dear Running: We think you should make an effort to go, even if it means arriving late. He's still your father, and your presence matters to him. And who knows? Maybe the third time's the charm. Dear Annie: I'm 73 and have been sending emails for quite awhile. I don't remember hearing that all caps means shouting. For many of us, finding the ''Caps Lock'' button is already an accomplishment. The alternatives you suggested to enlarge the lettering is so beyond our abilities, they could have been in a foreign language. I can't imagine any seniors getting upset about receiving a letter all in caps, even if it were shouting. Many of us are also hard of hearing. — N.D. Rose approved for use in the United DEAR DOCTOR K: I have States by the Food and Drug sleep apnea. My doctor has urged Administration, and received me to use a CPAP machine, but recognition in the 2012 Wall it's too uncomfortable. Are there Street Journal Technology other options? Awards, for which I have served DEAR READER: Sleep apnea as a judge. is a condition in which breathing — Expiratory pressure resisstops or becomes shallower many tance valves are disposable times each night. Obstructive Dr. K devices that stick to your nossleep apnea (OSA) occurs when by Anthony L. trils. The valves force your own your upper airway collapses or gets blocked during sleep. These Komaroff, M.D. breathing to pressurize your airway and hold it open. These airway obstructions starve your brain of oxygen and stress your cardio- devices have not yet been as carefully vascular system. Untreated sleep apnea studied as the MAS devices. You should also talk to your doctor increases your risk of high blood presabout medications you're taking. Medsure, stroke and premature death. OSA can be treated with a continuous ications can help or hinder sleep apnea. positive airway pressure (CPAP) For example, narcotic painkillers, sedamachine. A CPAP machine keeps your tives and muscle relaxants can worsen airways open as you sleep by delivering sleep apnea. On the other hand, a sleep continuous air pressure through a mask drug might help when you're first getworn over your nose and mouth. But ting used to a treatment device. Lifestyle changes can also help. If many people find it uncomfortable, and as a result, they use CPAP inconsistent- your sleep apnea occurs only when you sleep on your back, switch to sleeping ly — or not at all. Some new treatments may provide on your side. Try losing weight, which more comfortable alternatives. Discuss almost always reduces the severity of the pros and cons of these options with apnea. In some people, it eliminates the problem altogether. Finally, limit your your doctor: — APAP is an "autotitrating" version alcohol intake. Alcohol may make you of positive airway pressure (PAP). It sleepy, but it can worsen your sleep continuously adjusts the pressure in apnea symptoms. When a person's obstructive sleep your airway as your needs fluctuate durapnea is caused by very enlarged tonsils, ing the night. — Custom-made mouthpieces slide surgery (tonsillectomy) can cure the your jaw forward to keep your airway condition. However, it is unusual for open. They are called "mandibular there to be such a correctable cause of advancement systems," or "MAS" for sleep apnea. If you do decide to try a treatment short. In recent years, studies have shown that MAS devices really work — device, remember that it works only if and nearly as well as CPAP and APAP. you use it. For people who cannot tolerate CPAP, Dr. Komaroff is a physician and these devices can be valuable. — Another device called Oral Pres- professor at Harvard Medical School. To sure Therapy creates a negative pressure send questions, go to AskDoctorK.com, that "sucks" the tissues in the back of or write: Ask Doctor K, 10 Shattuck St., your throat forward, preventing the col- Second Floor, Boston, MA 02115. lapse of the upper airway. This device is When a doctor doesn't take Medicare What does it mean applies to services prowhen a doctor tells you vided by the doctor or he or she has "opted out" other provider who asked you to sign it. of Medicare? You don't An opt-out have to sign a doctor is one private contract. who doesn't You can always a c c e p t go to another Medicare. Docprovider who tors who have does take opted out of Medicare. If you Medicare can do sign a private charge their contract with Medicare your doctor or patients whatother provider: ever fees the • Medicare physicians David won't pay any choose. These amount for the doctors don't services you get submit any from this doctor health care claims to Medicare. In or provider, even if it's a addition, opt-out doctors Medicare-covered seraren't subject to vice. • You'll have to pay Medicare laws that limit the amount they can the full amount of whatever this provider charges charge their patients. More than 1 million you for the services you health care providers get. • If you have a throughout the United States – the vast majority Medicare Supplement of them doctors – accept Insurance (Medigap) policy, it won't pay anything Medicare as payment. But when you visit a for the services you get. doctor who has opted out Call your insurance comof Medicare, you pay the pany before you get the entire cost of your care, service if you have quesunless it's an emergency tions. A physician or other or you need urgent care. Generally, Medicare provider must tell you if doesn't pay for health Medicare would pay for care services you receive the service if you get it from another provider from an opt-out doctor. If your doctor has for- who accepts Medicare. mally opted out of Your provider also must Medicare, he or she must tell you if he or she has have you sign a private been excluded from contract stating that you Medicare. And keep in mind that agree to receive care from a doctor who does- you can't be asked to n't accept Medicare. This sign a private contract for private contract only emergency or urgent Sayan care. You may want to contact your State Health Insurance Assistance Program (SHIP) to get help before signing a private contract with any doctor or other health care provider. Your local SHIP number is available by calling 1-800MEDICARE (1-800633-4227). Most doctors, providers and suppliers accept Medicare, but you should always check to make sure. (You can always get services not covered by Medicare if you choose to pay for them yourself.) Providers who participate in Medicare have signed an agreement to accept the Medicareapproved payment for all Medicare-covered services. In other words, they "accept assignment." Here's what it means when your doctor, provider, or supplier accepts assignment: • Your out-of-pocket costs may be less. • Your provider agrees to charge you only the Medicare deductible and coinsurance amount and usually wait for Medicare to pay its share before asking you to pay your share. • Your provider has to submit your claim directly to Medicare and can't charge you for submitting the claim. If you have a Medicare Advantage plan, also Urban announces new album, waits on 'Idol' NASHVILLE, Tenn. (AP) — Keith Urban is no different than the rest of us: He has no idea what's going on with ''American Idol.'' ''I have no official information of anything,'' the 45-year-old country singer-guitarist said. ''I'm pretty much in the same boat as everybody else here with the rumors that have been floating around. I don't know anything more about what's happening next season. It was like this before I signed on ... so it's not unusual for the 'Idol' folks to be in this place of figuring out what they want to do, then they always pull it together.'' Urban's got plenty to distract him while he waits. The Australian country music star has set a Sept. 10 release date for his new album, ''Fuse,'' and that means he's got to finish it. Urban thinks he's got a few months of work left to do on the follow-up to 2010's ''Get Closer,'' but leaves on tour in mid-July and hasn't left himself much of a cushion. These things usually don't take so long, but Urban is using a new approach with ''Fuse.'' He is branching out from his longtime partnership with producer Dann Huff. While Huff is still onboard on a handful of songs, Urban signed up Jay Joyce, known best in country music for his work with Eric Church and Little Big Town, and Taylor Swift collaborator Nathan Chapman. He's also enlisted rocker Butch Walker. Urban went to their studios, used their engineers and players, and tried to expand and infuse his sound with their energy. He released the first single, the Chapman-produced ''Little Bit of Everything,'' on May 13, and country radio responded positively. ''It's just been really creatively liberating to me,'' Urban said. ''I love collaborating. It's the thing I've always loved doing, whether it's writing or performing or being in the studio, I love the collaborative process. I think finding people's strengths is the thing I love the most.'' known as a Medicare private health plan, you should see doctors within your plan's network. You typically pay the least if you go to a doctor who's in the plan network. Check with your plan to see what rules apply. David Sayen is Medicare's regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800MEDICARE (1-800-6334227).