3008 2009-2025 Form

27 December 1999. It was at 4.30 in the morning.It was during the month of Ramadaan, and my father was having breakfast with my three siblings and I when the phone rang. Everyone in the house went pale.I answered the call.The nurse on the other end of the line asked to speak to my father. There was a sense of urgency in her voice that I will never forget. Two minutes later Dad was out of the front door and tearing down the street as fast as his yellow Toyota Corolla could take him.I was in left in charge of my siblings; I had just recently turned 18 years old.At 4.45 the telephone rang again. Once more, the nurse asked for my father.I told her that he had already left for the hospital, and asked her what happened. She hesitated… and then told me that they would wait until my father arrived.In that moment I knew that my mom has passed away. She had spent a lifetime suffering from the devastation of Lupus and had finally succumbed.On the 27th of December 1999, I saw my father crumble. I saw my siblings, aged 9 through 14, lost in a way that nobody should bear witness to.On that day I made a resolution to take myself out of the equation to be able to say “fuck everything and stand firm” to keep going so that others didn’t need to push so hard to try and pick up the pieces of their lives.On the 27th of December 1999, I decided to step up the the plate, and in that moment I lost my childhood.

Not at the diagnosis itself but getting here has been kind of amusing.A few years back, a doctor looking at a chest x-ray noticed that I had a healed crushed vertebra. I knew that I had hurt my back a year earlier but didn’t realize it was a crushed vertebra. When I told her that I got it lifting a shop-vac into my pickup truck, she was suspicious. As a (then) early 50’s male, I shouldn’t have bones getting crushed for something that innocuous. She ran some tests that showed that I had abnormally low bone density but everything else was fine. She suggested that I see a specialist.After a (long story) while I get to see an hematologist/oncologist. They start doing some measurements of protein in my blood. The value keeps rising. Bone marrow and biopsy tests from my hip shows unusual cells. The doctor says I have Waldenstrom’s macroglobulinemia. But … they keep testing and the protein value roughly stabilizes. It’s too high but not high enough for a definitive Waldenstrom’s diagnosis. I have Monoclonal Globulinemia of Unspecified Significance, MGUS. Treatment is to watch and wait to see if it develops into something more serious.This summer, I crush another vertebra lifting up a computer. MRI scan shows a tumor in the crushed vertebra and the vertebra next to it as well as some other damage. Diagnosis? Multiple myeloma.I get signed up for a clinical study for multiple myeloma. Doctors need to get another bone marrow and biopsy from my hip to baseline my condition before starting treatment. Diagnosis? Not multiple myeloma. It’s Waldenstrom’s.The hematologist wants to have a back specialist take a look. When I see the very experienced back specialist he says that he’s never seen Waldenstrom’s lead to crushed vertebra. Diagnosis? It’s probably multiple myeloma.But, importantly, he says we can’t keep guessing. We need to get a bone marrow and biopsy test from the vertebra to be certain. Result? It’s Waldenstrom’s. Everybody is now in agreement.I know way more about my immune system than I ever expected to know.

In 2001 my husband’s uncle went missing. He was in his late 60s and had emphysema. We kept calling his house, but he didn’t answer his phone. We finally went to his house and his cars were there, but Uncle Art and his dog were both missing. He lived an hour or so away from us.After a little bit a neighbor in his back yard talked over the fence asking if Art was there. My husband told him no that he is Art’s nephew. The neighbor then told us that when the mail carrier delivered the mail several days ago Uncle Art yelled at her for help. She called 911 and an ambulance came and picked him up. No neighbors had seen him since then. The neighbor also told us what hospital they thought he would have been taken to.We called the hospital asking for him and they said he was not there. We called the police and put in a missing persons report. Then we took one of his phone books home with us.The next day I stayed home from work and proceeded to call all the hospitals in the area. Uncle Art lived in El Segundo, California and there are a lot of hospitals in the area. Every hospital I called said he was not there. I then called nursing homes in the area. One of the nursing homes said he was there so I then called my husband and told him where his uncle was. My husband wanted me to call the nursing home back to see if they had visiting hours. When I called back they asked who I wanted to visit and I gave them Uncle Art’s name. They then told me that they did not have a patient by that name.Getting frustrated I called the fire department that sent the paramedics to his house. They told me they could not tell me where they took him because we might go there and hurt or kill him and then they would be responsible. So how in the heck are you supposed to find a family member who has been taken to the hospital?I called the original hospital that the neighbors said would have been the mostly likely hospital in the area that they would have taken him to, and asked if Uncle Art was there again. The lady on the phone hesitated so I jumped right in and told her his Social Security number and driver’s license number. She then gave me the name and phone number of a doctor. At last I was getting somewhere.I called the doctor’s office and the doctor was not in. The person who answered the phone said that the doctor would call us when he got in. A few hours later I got a call from the doctor and he informed me that Uncle Art had passed away. He also said that he had no family. What the heck? I let him know that he does have a niece and a nephew who was my husband. Uncle Art was my husband’s father’s twin brother. My husband’s father had passed away a few years prior to this.Apparently Uncle Art was in the morgue at the first hospital that we called. I don’t know why they didn’t give us the doctor’s name and number the first time we called. It is not like we can go kill someone who is already dead.We also found out that someone had come and taken Uncle Art’s dog and at the same time they were supposed to look for relatives. Whoever came did not talk to the neighbors and totally ignored the message next to the phone that said to call my husband in case of emergency. I don’t know who that person was, but they failed at their job.We went to the post office a couple of days later to get Uncle Art’s mail. The mail carrier had put a stop on his mail the day he was taken to the hospital. We filled out a form to get his mail and to forward it to our house. Without even asking who we were or asking for identification, they just brought out a bin full of his mail and did the mail forwarding. I was shocked that it was so easy. Anyone can forward your mail to another address and they won’t ask a single question. No wonder it is so easy to steal someones identification.Someone we talked to, I don’t remember who, told us that if we did not put a claim on his estate immediately everything he owned would go to the state. So we called someone we knew from our church for a recommendation for a lawyer. We then called the lawyer and they said that we were being lied to about that. We hired her to oversee his estate and get us through all of the legal issues. Uncle Art told my husband that he had a will, but we went through everything in his house and never found one. We even called the lawyer who handled Uncle Art’s father’s will and they said they had not done one for Uncle Art.Someone from the police department called a week later. They asked me if we had found him yet. Apparently when someone finally looked at the missing person’s report a week later, all they did was call me. It would have been so simple for them to call the ambulance company and get the information, and then call the hospital to find out what happened to him on the same day that we put in the report. They could have found him within a few minutes. But the police obviously did not care at all that an elderly man was missing and the family was frantically looking for him. I see stories about missing elderly people on the news all the time. I don’t know how they get attention when our uncle got absolutely no attention. At this point I am surprised that they even came out to take the report.We did have a nice funeral for Uncle Art with his family and neighbors and then shipped him across the country to be buried next to his parents and sister in New York. Luckily the ground was not too frozen to bury him.Rest in Peace, Uncle Art.Update 7/25/2018:Several people have asked what happened to Uncle Art’s dog. We are not sure what happened to the dog. It was a Chihuahua named Meanie because he bit people all the time and was not house trained. We did not want the dog so hopefully whoever picked it up found a better home for Meanie. We didn’t even know who picked the dog up or where they would have taken it. We had a hard enough time just trying to find Uncle Art.

Getting my medical license.The process is so painful that sometimes I feel like stabbing myself in the heart and gouging my eye out, and jumping off a bridge at the same time. And the most frustrating part of it is that there’s not a single thing I can do to speed things up.The website isn’t very user friendly.They request way too many documents. Like, you need to submit 6 different things to prove your citizenship. Can’t it be assumed that if the Federal Government gave me a passport, they know that it’s because I’m a citizen? Can’t it also safely be assumed that if I graduated from a residency program, I must have graduated from a medical school at some point?The website doesn’t tell you everything you need to send. After you’ve filled out the application online, there is a PDF you’re supposed to find somewhere. The PDF was the old application form. You’d fill it out by hand or by editing the PDF. If you did that, you’d see an number of appendices that told you what other documentation you were supposed to supply. But if you apply online, there’s nothing to let you know what you’re missing. So, you have to call them. When you do, they tell you that you need a bunch of stuff you’d never have guessed: a background check, forms you’re supposed to submit to your residency programs, etc. Why not put that in the online application?Then, after you do all that, you might wonder if your file is complete. So, you call. They’ll tell you that your application hasn’t been processed yet. How long till it gets processed? 3 to 4 weeks! So, they won’t even look at your file for 3 to 4 weeks. And, 3 to 4, of course, means 4. Then, when they look at your file, it might even be week 5 by the time they respond to you. At that point, they’ll tell your that your file is missing some stuff.You ask for clarification about the missing stuff, because you’re pretty sure you’ve already sent it. You hear nothing back for a week. You call them, only to hear that they thought they’d emailed you what you were supposed to fill out… You submit what they’re asking for, having wasted another week waiting. Then, they tell you that your file has been submitted for final approval. YAY!Then you’re told that, since you used to be a nurse, you should also submit a nursing license verification. Okay, no biggie, you think. You did a similar thing for Iowa a few years back. You’ll just go online and have the state of Michigan send the state of Tennessee some information about the nursing license that expired 6 years ago.You get on the Michigan website, and things are so disorganized that you can’t for the life of you figure out how to submit the verification request. Oh, and the process has changed. In 2015, you could use the Nursys verification site. But Michigan has pulled out of this process, because… just because. Now, you have to call during business hours, realize that you’re supposed to download and fill out a form, attach a money order (you can’t pay online anymore), and mail it to a P.O. Box.You do that, sending it by express mail. You call the next day to see if it’s been received. Now you’re told that if you want to send things by express mail, there’s another address you should have sent it to, an address that was never communicated to you when you talked to the Michigan people on the phone. You learn that sending mail to the P.O. Box means that it will sit there for a week, after which it will be processed by the Cashier’s office/Finance office/Treasury office, then slowly make its way to the Bureau of Licensing… this process might take 2 weeks. At this point, you’ve sent your initial application 8 weeks before. You wonder why it is that the process couldn’t be more streamlined. Why couldn’t they be a uniform process for all states? Why couldn’t they at least be a central database where healthcare providers could send their documentation, so that whenever they apply for licensing in a new state, that state can immediately receive all the relevant documentation. You’re powerless. You try to think of other things you might do.You remember that Iowa must have a copy of your nursing verification license. You wonder if you could talk to them and see if they’d share it with you. You’re told that they will emphatically not release the document to you. Why? Who knows. Anyway, they might consider releasing it to the Tennessee people if they are contacted directly by their Medical Board. You sheepishly ask the people in Tennessee if they’d be willing to contact Iowa, giving them a phone number, email, and fax number, knowing full well that it will be to no avail.You decide that maybe, if you were to track down the cashier’s office in Michigan, you could fly there and make the payment in person, in a bid to speed up the processing of your license verification request. It’s after hours now, so you can’t be sure. There’s a plane early in the morning. You could fly to Detroit, rent a car, drive to Lansing, and give it a shot. But… what if it doesn’t work? You decide to wait until the morning and call the office to see if getting there in person would make a difference. You are told that it is impossible to make a payment in person, because… rules. There’s literally not a damn thing you can do.And that, my friends, is the story of my life right now. The most frustrating part of this saga is that not only can I not work, but I’m sort of homeless right now. Let me explain. A while back, I bid on a house. I used what is called a physician loan. What my lender did not tell me is that you need an active medical license. So, we were a week from the closing date before I learned this. At this point, I had three options:Walk away from the home purchase and rent. This wouldn’t have been a terrible idea.Prolong my temporary lease at the place I was renting. I would not do this because I hated, hated, hated them with their nickle-and-diming tactics.Wait for my license.I opted for number 3, because I thought it couldn’t take much longer until I’d get my license. My belongings are currently in storage. I’m staying with my sister in Florida. It’s not the worst thing that’s ever happened to anyone in human life, but it’s still really frustrating. The only bright spot is that I get to spend time with my family. I have a nephew and two nieces here that I hadn’t seen in 9 months. They’re growing so very fast. I am constantly peppering them with mental math questions, but they seem to love me for some reason. So, all in all, things could be worse.

That will entirely depend on how you choose to have your mail delivered. If you want all of your mail to go to your post office box only, then you will need to fill out a change of address form. If, like several of my customers, you run a business from your home and want your personal mail to go to your home and your business mail to go to your post office box, then it will be up to you to notify others which address to use. Be aware, though, that you cannot do an individual change of address out of that post office box being used as a business address. I had a situation, years ago, where the chief of police used the police departments PO Box as his personal mailing address. When he ended up being fired by the village government, the Mayor, as the current owner of the box, requested that the lock be changed on the PO Box, and the former employee no longer had access to his own mail. As the box was a business address he could not file a change of address order for his individual mail. This holds true for street delivery as well. Individual changes can not be made from business addresses so I always recommend that people use a PO Box for their business address. That is why I always tell people never to have mom or dad’s mail sent to a nursing home but to have it go to whichever child the parent chooses to receive it. You will be at the mercy of said nursing home to hand forward to you any important mail you may need to close out their estate when they pass away.

My favorite hotel service experience was the one where the hotel staff actually turned a negative experience into an incredible positive.I was staying 2 nights at the Aloft Downtown Chicago on business. On the first morning, I went to iron a dress for my meetings. The minute I put the iron on the dress, I realized the protective coating on the iron was melting and it immediately put a sticky stain on a beautiful silk Theory dress.I brought the dress to the front desk and told them what happened. They apologized and told me they’d have it cleaned while I was at work that day.When I returned to the hotel, they had indeed had it cleaned but sadly the iron had left burn marks that couldn’t be removed. The staff had checked the dress on return and, realizing this, had found already found an identical replacement. To take it a step further, Theory was no longer selling the dress, but they had found one online in my size and color at a department store. It was not in the Chicago so they had it express delivered to my apartment in New York City - it was waiting for me when I got home from my trip.That dress cost more than my 2 night stay at that hotel.Perhaps the iron WAS the hotel’s fault and they WERE liable, but they went out of their way without so much as a complaint from me and it absolutely made my day. I’ve told so many people this story and recommend that Aloft every time someone tells me they are headed to Chicago. Doesn’t hurt that it is also home to my all-time favorite hotel cafe and restaurant (Beatrix).

Teaching.No offense to teachers (I’m also qualified as a high school teacher and used to teach). I have great admiration and respect for teachers (like Matthew Bates, Dave Consiglio, Jon Davis and other excellent teachers here on Quora) but teaching is not a specialized job.By that I mean almost anyone can become a teacher. You don’t have to be an expert or specialist to become a teacher. At least not in my country, at school level. (At university level it is somewhat different - someone like Professor Richard Muller is obviously an absolute specialist and expert in his field).Make no mistake, even at high school level there are some great teachers who happen to be specialists and are doing a great job. But they are in the minority.Too many teachers are mediocre at their subject, and not particularly gifted at teaching.For example, I have met some teachers who teach business studies as a subject. But they can’t teach, they suck at explaining things or inspiring kids, have never started or run a business of any kind, and would never survive in the business world. Yet they are tasked with teaching the next generation about business.The same with other subjects, such as art teachers who are not artists, have no talent for art or teaching, and have never sold a single artwork.The saying, “Those who can, do; those who can’t, teach” does not apply to all teachers, and disparages the noble profession of teaching, but I wish it would say, “Those who can, do; but only the best teach.”Wouldn’t it be great if the world’s greatest artists could teach art one day per week? If successful business owners could teach business at school? If great scientists or mathematicians could teach science and mathematics?And wouldn’t it be great if all those who teach our children were true experts not just in their subject matter, but in the art of teaching.Imagine if becoming a teacher was considered the highest career achievement in a particular field, and if teaching was the highest paid profession. It would attract the world’s best talent and top specialists in every field.Having said that, I tip my hat to all the excellent, hardworking teachers out there who are brilliant at what they do. At the moment teaching is a poorly paid profession and a labour of love.

Aging gracefully.  Tough topic for a blog, but a worthy one.  I think aging gracefully differs from person to person.  I was asked to answer this question as an expert on plastic surgery. So instead of looking at the deep meaning of aging gracefully as others have answered, I will focus on just the face and the skin deep. In my plastic surgery practice I see some patients who don't want to see a single wrinkle; they want to defy aging altogether.  I think in pursuing their goal, sometimes they lose sight of what natural is.  I see people who are too plumped, too tight, too high, too frozen.    My definition of aging gracefully involves looking like you do not know a plastic surgeon.  When cosmetic procedures are done well, you don't see them.  You look "good for your age."  And the overwhelming reason I see patients want procedures isn't to look 20 or look like someone else.  People are living longer, healthier active lives.  They are working longer.  When they seek me, it is because how they feel on the inside is not in synch with how they look on the outside.  On my website, I have common surgeries and procedures by the decade.  Though we all feel unique, there are common patterns to aging.  For more in depth on subjects, please look there Plastic Cosmetic Surgery Palo Alto San Jose Bay Area.  What follows is general information.  Of course you need an evaluation by a doctor to see what is good for you, and a board certified plastic surgeon who does non surgical and surgical procedures is best.  (If you see someone who cannot do an eyelift, they may not recommend that as a treatment though it may be what you need.) Starting early and beyond the focus is on skin.  Healthy skin is pretty skin.  Here you should listen to what your mom tells you.  "Wear sunscreen"  "Don't smoke."  "Eat healthy."  "Wash your face."  Skin care products are not equal.  Find a product with good science behind it.In your 30s is a mainstay.  If you have no wrinkles, don't do .  does not prevent wrinkles.  It is good for those who have wrinkles to keep them from deepening, particularly when you can see a wrinkle at rest (when you aren't moving your facial muscles.)  It is best for the forehead, the area between the eyebrows (scowl be gone!), and the crows feet of the eyes.   Who you go to and how they inject is important.  There is nuance to .  Having a frozen forehead and spock like eyebrows is not graceful.In your 30s skin care ramps up.  Use of antioxidants and can help reverse some earlier damage, as many of us were not as good with sunscreen as we should have been in our teens and 20s.  Active skin care products are usually available only through doctors offices and may not be baby safe.   Peels and lasers may help as well, but know that all "peels" and "lasers" are not equal.  To know which ones do what, the downsides, and which are all hype would be a textbook in itself.   In your 40s "looking tired" frequently sets in.  This could be from the juggling balance of work, kids, and life, but as I stated at the beginning of this blog, I will focus on the skin deep and the face.   Your face loses its volume as you age, and this is when you really start to see it.  The loss of cheek volume, the fine lines around the mouth, the always "looking tired" tear trough issue.  Non surgical in office fillers can be fantastic to reverse those subtle signs of aging.  To fill you can use many things: HA fillers like , , Juvederm, or other types like .  For a longer lasting effect, you can do a small surgeries like fat transfer to the face (where I liposuction fat and do microinjections similar to the sites I fill with HA fillers. I love this surgery as it moves fat from where you don't want it - belly, love handle- to where you do.)  Fillers do not have to make you look fake, over plumped, and lineless.  As with many things, there is nuance to injecting.  Find a skilled surgeon.  As the major face issue is not skin laxity, facelifts are usually not needed.   But in your 40s is when the first surgical facial procedures tend to happen: the eyes.  When you start to get extra crinkly around the eye, get loose skin so you can't see the eyelid or your eyelid hangs over your lashes, eyelid surgery is a good idea.  To fix this is a simple surgery which removes the extra skin. Eyelid surgery alone does not make you look different.  (There is a common confusion about eyelid surgery versus brow surgery.  Eyelid surgery does not raise the eyebrow, change the shape of your eye, or make you look surprised.)  When your eyes are done you emerge looking true to you, just a little brighter. In your 50s things may advance to more complex procedures like browlifts and facelifts.  To age gracefully at this point, I recommend finding a doctor who looks at the whole picture and addresses these in a balanced, thoughtful approach.  There is no one fix.  The causes of looking old are multipronged, so the fix should be multipronged as well.  And beware of quick fixes and no downtime procedures.  The wisdom of "it sounds too good to be true" generally is correct.  To age gracefully involves looking at all the components of the face: skin quality, volume loss, and skin laxity.  To age gracefully involves addressing all of these subtly, consistently over time.  And don't forget there is a beauty in age.  In reading other answers I am reminded experience, confidence, kindness, love, and determination also help us age gracefully, but alas, as I am the plastic surgeon asked to write, I leave others to expound on these as these qualities are deeper than the skin.

The Affordable Care Act (ACA) HEvalth Insurance Marketplace (Marketplace) is the place where people who do not have hEvalth care coverage through their job or a government program, such as Medicare or Medicaid, can purchase hEvalth insurance.

By now most businesses and insurance companies are familiar with the Patient Protection and Affordable Care Act (PACA), sometimes referred to as ACA or Obamacare. ... Great land has three options, designed to fit your budget and business needs, to file Forms 1095-B and 1095-C to the IRS and send copies to your employees.

These include doctors' services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental hEvalth services, and more. Some plans cover more services. Plans must offer dental coverage for children. Dental benefits for adults are optional.

Beginning in 2014, large employers must track each employee's monthly status as full-time (defined under the ACA as an average of 30 hours per week, or at least 130 hours in a month) or part-time, report each employee's full- time status to the IRS, and keep as part of their tax records the status of each employee.

If an employer has 50 or more full-time equivalent (FTE) employees, the ACA requires that they offer affordable coverage to at least 95% of their full-time employees. Employees that work at least 30 hours each week are defined as full-time under the ACA.