The stupidity of American healthcare strikes once again

When I made my mammogram appointment over a month ago, the provider I was referred to by my OB-GYN had an online portal that had you fill out the usual paperwork in advance online, so I was able to do things like upload my driver’s license, front and back of my insurance card, and fill out any personal and family history ahead of time. What it also did was give me an estimate of what my out of pocket cost would be at the time of appointment check-in. This was a rude awakening: it said based on my health insurance that my out of pocket cost should be around $350 for a mammogram and breast ultrasound.

None of this sounded right. Mammograms are standard and covered by pretty much every health insurance for women over 40. Breast ultrasounds are covered in New York state (and apparently… not in Kansas, where a friend of mine lives, and where she had to pay $300 PER breast out of pocket). I called my health insurance, who confirmed to me what I suspected: I should have zero out of pocket costs, no co-pays, for either procedure. They gave me a reference number to give to the provider. I then called the provider, gave them the reference number, but they said they could not tell me the cost until I came into the office, which seemed not only completely inefficient, but just plain stupid. “If you ask me to pay for this out of pocket when I come in, I will decline the procedure and walk out,” I said sternly to them over the phone. “I am asking if you can correct this ahead of time so we don’t waste your time or mine?”

The person on the phone seemed totally unfazed, like she didn’t care (and frankly, probably wasn’t paid enough to care). She told me there was no way to confirm until the day of the appointment when I came in (which seems false the way health insurance works, but whatever). So she told me to just come in, and she doubted I’d have to pay anything out of pocket.

Well, I came in this afternoon, and lo and behold, that same $350 amount showed up as what I owed at the time of service. I insisted to the receptionist I wasn’t paying it. I gave them the reference number once again, and she made a flippant response: “Breast ultrasounds are not typically covered, but okay, we’ll call your insurance.” Her associate called my insurance. Twenty minutes later, they confirmed that I was correct, that I did not owe them any payment… but, I would be required to pay $20 copay for the breast ultrasound.

“Copay – is just for the breast ultrasound?” I said to her, still skeptical. I made a mental note, planning to call my insurance to contest even this amount after I paid it because this still goes against what my health insurance stated to me on the phone, which I wrote down with the reference number.

Yes, that’s what I said,” the front desk person said, clearly annoyed with me. I’m not sure what her problem was — it wasn’t like she was getting the money. Their office was the one who screwed up, not me.

I paid the copay, then had both the mammogram and breast ultrasound done. I walked out of the office much later than I estimated I would, so the whole experience was pretty frustrating, especially since I tried to prevent foreseeable problems way in advance, which this office obviously thwarted. But this is just one of many stupid, frustrating and senseless examples in my personal experiences of why our healthcare system in the U.S. is so fucked — an example of what not to be. I also made a note to ask my OB-GYN for another radiology provider because I definitely do not want to go back here at all ever, ever again.

Lunar New Year gifts this year

Every year I throw my Lunar New Year party, I try to do things a little bit differently to make it better, different, or more special with the food. This year, I made some more intricate Vietnamese dishes. I also created food labels for everything, even marking the ones that were vegetarian or contained pork/mushrooms/shrimp (for people with allergies to those foods). That’s partly to make my life easier with questions on ingredients/what the dishes are, so I don’t have to re-explain myself a dozen times, and so that people know what they’re eating right away. But what I wasn’t quite expecting this year is that the gifts we got were extra special, nice, or fun!

Kaia received several generous hong bao from friends, as it’s a cultural tradition that the older generation should give hong bao/li xi to the younger generation. One of my friends gave me a small money tree several weeks in advance for Lunar New Year party hosting. A third friend drove all the way from New Jersey down to Manhattan Chinatown to a popular (and pricey!) Malaysian jerky shop to get us an entire pound of pork jerky. She also gave us a couple boxes of bean-based pastas, a single orange for good luck (haha), and some homemade lentil-based breads she’d just baked. Another friend brought beautifully boxed and individually wrapped Japanese Yoku Moku “cigare” biscuits, plus an entire box of sumo citrus! I love sumo citrus, but they are quite expensive, so we rarely buy them. Originating in Japan, Sumo citrus are actually not an orange, per se, but a cross between satsuma, mandarin, and navel oranges. We even got a bottle of Veuve Clicquot. A friend who recently came back from India brought us a framed Madhubani painting, which is a style of painting traditionally done by women from her dad’s old village in Bihar. And then there was the most bougie gift of all that Chris’s friend gave me, perfectly wrapped in glittery pink wrapping paper: a Williams Sonoma gold and white ceramic dragon candle, made especially for Lunar New Year. I placed the candle, alongside my 3D cherry blossom birthday card from a friend, in our dining area to display them both. That huge gold candle definitely is the most flashy, showy thing I own to date now…

Year of the Fire Horse Lunar New Year Party

Today, we had a Lunar New Year party of 17 friends who came to feast on 12 different dishes that I made! It was our largest group hosted yet. We had 16 people, but then a friend of Chris decided last minute he could come. Chris asked if I had enough food. I had a mini panic in my head last night, but I figured that I could always supplement with additional dumplings I had cooked and frozen that were originally meant for future use.

Well, there was way more than enough food; I was actually shocked by the amount of food we had left over, which just means that we’ll have more to eat (and less need for me to cook!) for this week. This year, in true form, I “upleveled” and tried out some new recipes, did my usual trusted staples, and also added more Vietnamese dishes (which were quite labor-intensive!) to the line-up. After prepping for two weeks and deciding on this menu about a month ago, this is what I made:

Starters:

Banh it tran – Vietnamese (Hue) sticky rice dumplings filled with mashed mung bean and minced pork, topped with scallion oil, fried shallots, and served with nuoc cham

Banh bot loc – Vietnamese (Hue) banana leaf steamed tapioca dumplings stuffed with shrimp , served with nuoc cham

[Do chua – pickled carrot and daikon (for both dumplings above, plus thit kho as a palate cleanser/much needed acidic hit)]

Luo bo gao – Chinese pan fried radish cake with Chinese sausage, shiitake mushrooms, and shredded scallops

Mains:

Thit kho – Vietnamese coconut water braised pork ribs with eggs

Nuo mi fan – Chinese sticky rice with Chinese sausage, cha siu, shredded scallops, shiitake mushrooms

Dan Dan noodles

Steamed wild black sea bass with ginger and scallion

Blanched yu choy greens with black vinegar sauce and crispy garlic

Buddha’s Delight / Luo han zhai: Stir fried (12!) vegetables with mung bean noodles

Desserts:

Black sesame swirled pumpkin nian gao

Chinese almond cookies

Black sesame tang yuan

Food is one of my love languages. I love feeding people I love. I love it when people discover new foods and enjoy them, and I love when they discover new foods they enjoy because of me. And I love it when people love the food I make them. One friend discovered she loved lotus root and the different tofu products in my zhai dish; she also loved the do chua/pickled carrot and daikon for my Vietnamese dishes. Another friend was obsessed over the savory-sweet flavor that the coconut water gave my thit kho/pork ribs. A friend who came for the first time said she couldn’t get enough of my steamed fish and how flavorful it was. A friend also was excited to have my black sesame tang yuan again — this is someone who is self-professed about being anti-dessert, but loves these sticky rice balls of “not too sweet” black sesame filling.

It’s definitely a lot of thought and work to put into this party, but I love every bit of it. I love the lead up, the food prep, the last minute bits that have to be cooked, the chaos that ensues with the kids coming in. And I always end the evening, after lots of cleaning and washing, with a happy and warm heart.

High protein everything

One thing I’ve done to address my weight issue is to see if I can consume more protein. I’ve already been adding a protein supplement to my midday smoothie, along with additional flaxseed, hemp seeds, and yogurt. But I’m trying to figure out how to get more plant-based protein into my diet without feeling like a rabbit. And so I found this interesting “high protein peanut noodles” recipe that takes a whole block of silken tofu and blends it into a sauce with peanut butter, soy sauce, garlic, ginger, chili paste, and other ingredients to create something that is not only high protein but also delicious and satisfying. I was actually shocked with how much I liked it: I was licking the spoons clean.

I liked this sauce so much that I sent it to my friend, who is also exercise and health obsessed. And she was so excited about it that she decided she would make it for dinner tonight!

Feeling 40 in my midsection

Now that it’s been over a month since I turned 40, it’s almost like I have little things here and there to remind me of my age. I just scheduled (and rescheduled, due to this week’s blizzard) my first mammogram. I also realize that as I am checking my weight on the scale weekly that my weight really hasn’t come down much from when we first got back from Australia and the Philippines. Usually, this is what happens each year: the second week of December, we leave for Australia/Asia. We’re gone for about three to four weeks, during which time, I do no real exercise (my workouts are all on hold) other than casual walking (which frankly, I do not think is enough for anyone at any age). In Australia, we’re always getting to places by car, which means even fewer steps. And I’m definitely indulging more since we’re away from home, we’re trying new places in different cities, and it’s Christmas time, so ’tis the season for indulging. So with all that lack of movement and increase in indulgent foods, it’s no wonder that by the time we get back to New York the first week of January that I’ve usually gained somewhere in the ballpark of six to nine pounds. And since my baseline weight is at about 117 pounds, percentage wise, that’s actually a good amount of weight for me to gain on my 5’3″ frame. So I spend the next month to month and a half cutting back on indulging, not drinking much alcohol at all, and also increasing the rigor of my exercises.

I checked the scale last week, and I checked it again today. My weight is not budging much. I came back at 125 pounds, and today, I am 124 pounds. I’ve lost a single pound of weight. It’s fluctuated down to 120 at some point in early February, but it’s gone back up again. And I am definitely not pleased. And I know where most of it is concentrated: excess fat right in my midsection, the area they always tell you that as you get older, you need to watch more carefully.

So now I’ve become one of those people who checks her weight semi regularly and is trying to figure out how to lose weight. This is all relative to myself, and most people cannot even tell from looking at me that I’ve gained weight. But because I know and can feel the difference, I suppose it’s time to start making some age-related tweaks to address this — not fun.

Friends reunion and health scares

Today, I had a midday meet-up with a college friend who was in town for her kids’ winter break. They came into the city to have a quick midday snack with me before driving back up to Boston. Her kids are obsessed with the American Dream Mall, so they visit about once a year during a school break. I’ve been able to see her both last year and the year before for dinner while I was in Boston for work, but both times, it was just herself. This time, I got to see not just her, but her husband and all three of their kids! The last time I saw her husband was before they even got married. And I was excited to meet all three of her mini-mes today.

The two older kids were very sweet and affectionate and prompted addressed me as “Auntie Yvonne,” giving me a hug, and making sure I knew how old each of them were. The youngest one was 15 months, and he was like a quiet little koala. This is my “go big or go home” friend when it comes to kids: she always said she either wanted zero kids or a LOT of kids. And so now she’s got three. And just before I was going to ask if they were considering a fourth (because this time last year, she told me she and her husband seriously were talking about trying for a fourth!), she told me that they are officially stopping at three because their number 3 child had a very tumultuous first 15 months on earth, with getting RSV at two months and rhino virus at four months; both required multiple night-long hospitalizations. And then just before Thanksgiving (and his first birthday), he started vomiting, and his stool was coming out with blood. They found out that he had intussusception, which is a medical condition where one of his intestines slid into another part of his intestine; they said the most common way to understand what’s happening is to think about how a telescope slides its way in and out. It was a result of having multiple back to back viral infections — poor little guy. And the only way to resolve this was to have him do surgery where the surgeons would cut him open and manually pull the intestine out of each other. Luckily, no parts of the intestine had died (this is a real fear if it’s caught too late), and he made a quick recovery. This little one-year-old was out of the hospital, post-operation, after just a one night stay! In retrospect, they said they really had it good: their first child never got sick and was super easy as a baby and toddler; their second child got sick occasionally but was also pretty chill. This third child, as is evident, keeps giving them one scare after the next!

I think about these crazy situations that can come up that are completely out of our control, and I’m just so thankful that Kaia has, to date, been pretty healthy (and fingers crossed, this continues). I don’t know how I could stomach a situation like my friend’s third child had — to think of a tiny little baby needing to be cut open for surgery just makes me want to cry my eyes out. My friend and her husband are definitely troopers in their own right — and the most fertile couple I am friends with, by far!

Homemade milk bread rolls

Several months ago, I successfully made a loaf of Japanese milk bread. I originally attempted this during the pandemic, but I didn’t have bread flour and only had all-purpose, and the bread was completely wrong — not the fluffy, airy, super moist bread that you think of when you hear of Japanese milk bread. When I finally attempted it again last year and succeeded, I knew I had to make this bread more often. It’s so satisfying to make, and as long as you have the right ingredients (as in, bread flour for higher gluten development, dry milk powder, and instant yeast as opposed to dry active yeast), then it’s pretty much fool-proof. While cooking and baking (desserts) have always been fun and satisfying for me, baking yeast breads has a whole different level of satisfaction for me. I love every part of the process — measuring out the ingredients, mixing and kneading the dough, watching the two rises, and baking. I look at every bread I’ve made as though it were my little baby — being made, grown, and developed. Tonight, I baked up the milk bread rolls after mixing and kneading the dough last night. I started mixing after I put Kaia to bed last night. She knew I was in the kitchen and kept calling out to me.

“Whatcha doing, mama?” she called out from her bed. “Are you cooking?”

I went back to her bed to settle her down and try to get her to close her eyes. “Mama is making bread, baby!” I said to her. “If you’re good, then maybe you can have some when it’s ready!”

Kaia loves “soft bread.” She loves to remind me of this. When she says this, she means that she loves soft, fluffy bread with a tender crumb — brioche, challah, and milk bread are all in this category. She also does not like a crunchy toast the way I do. Are these the most nutritious breads? No. But they are deeply satisfying to make and eat. And I always get excited whenever my baby enjoys anything I make with my own hands.

Speaking of nutrition, though, I was thinking about this recipe developer/cookbook author I follow and love, who is currently pregnant and was diagnosed early on with gestational diabetes. While I’m sure this was frustrating for her as someone who loves food, one interesting thing she shared was that when she bakes her own bread from scratch, her blood sugar levels do not spike. But when she eats bread not made by her (so bought outside), her blood sugar goes crazy. If you know of anyone or have yourself had gestational diabetes, you’ll know that in dealing with this during pregnancy, you have to prick yourself at least once or twice every day and carefully monitor your blood sugar level to ensure it doesn’t go over a certain amount. So when I heard that homemade bread didn’t spike her blood sugar, I felt a bit better about my love of making these “soft breads” that are not made from whole wheat or whole grain flours. Though i will say openly that I do do slightly sacrilegious things and add whole wheat flour to my brioche and challah to increase the nutritional profile.

I was almost 40 years old when I discovered glass nail files

I’ve had a nail and cuticle picking habit since I was about 12 years old. I have a feeling that some of it is genetic, as both my dad and Ed are nail and cuticle pickers. I tried all kinds of things to resolve this: I tried different nail oils and creams. I cut and filed my nails down really short (which is actually more hygienic given I cook so much). Chris and my friend even yelled at me regularly when they’d catch me picking. Nothing ever helped other than getting manicures, which tended to get very expensive and is a huge time commitment. There was a period in my mid-twenties when I actually did my own nails regularly in between having different vendor partners pay for manicures. But then I got too impatient and let it go. I realized that if I liked the way my nails looked (perfect, polished, manicured), then I wouldn’t be tempted to pick at them. And then once Kaia was born, the idea of doing my own nails or going to a salon just seemed like too much — too much time, too much money, too much dedication. Plus, regular nail polish doesn’t last long when you have kid responsibilities and cook regularly. I don’t want the risk of flaking nail polish into our food!

So I was reading about DIY “natural manicures last year. I found some kits that were in the $40-60 range, and this all seemed crazy to me. But then when I read the reviews for these kits, I realized that the key part that everyone raved about was the glass nail file — this seemed to be the real game changer. I vaguely remember buying (and breaking…) a glass nail file back in my 20s. The reviews say that if you commit to using a glass nail file, you don’t even have to cut your nails anymore. You file in one direction, and your nails will be super shiny and nice without any product.

I found highly rated glass nail files on Amazon late last year. I even brought them to Australia/the Philippines. Once I used them, I couldn’t believe it had taken me this long to find them. My nails no longer had the annoying jagged edges that would snag like when I file with a (terrible!) cardboard or plastic nail file. The nail tips actually were shiny because of the glass; I couldn’t believe it. So because of this one change, I’ve actually stopped picking at my nails since December. I still pick at my cuticles, but that’s another problem to be addressed. It’s one thing at a time!

I’m still oiling my cuticles regularly to prevent the dryness (which then tempts me to pick at them), but my nails have honestly never been better. What a find that’s benefited my nail health – glass nail files!

Yellow card goes missing; and a silver lining in the world of American healthcare

Last summer when we went to South America, Chris got into a tizzy because he couldn’t find our official yellow cards, showing proof that would be recognized by any government around the world that we were both vaccinated against yellow fever. In the end, thankfully, we didn’t need them, but he still wanted to figure out where the cards went. Neither of us ever found them; we have no idea where they went or how they would get lost, especially since both of us are pretty anal with documents of that nature. So he suggested that I at least try to reach out to my travel medicine clinic in the city to see if they still had my record.

I called them yesterday and asked if they still had my record; luckily they somehow did, even though they told me they typically discard records after ten years. I had my yellow fever vaccine done in May 2014, so that’s almost 12 years ago now. I did that in preparation for our Brazil trip, which was in June 2014. They told me that to fill out the yellow card, I’d just need to stop by their office during regular hours and pay $35 for the card. I came in today with my credit card ready.

Not only did they already have the yellow card ready and filled out for me at the desk, but they also told me a piece of unexpected news: they asked the doctor about my yellow card, and they told the front desk to waive my $35 yellow card fee completely. I was floored; how often do you get any fee waived regarding anything American healthcare related? Most doctors, facilities, and health insurances just want to take everything they can get for you. I just couldn’t believe it. I thanked them profusely, secured my new and free official yellow card in my purse, and walked out.

It’s so nice to have a pleasant surprise like that in the world of U.S. healthcare, which is one of the worst parts of the U.S. I left the travel medicine office feeling hopeful.

The necessity of soup at the Chinese dining table: an ode to my paternal grandma

Growing up, I remember there was almost always a massive stockpot full of some kind of broth or soup on the stove. Sometimes, it was a gentle herbal chicken soup. Occasionally, it was a thick and packed jook/congee with lots of different proteins, like chicken, pork, tofu skins, shredded dried and rehydrated scallops. Other times, it was a ginseng-based tonic meant to “cool” our bodies from eating too many rich foods. Regardless of what was in the big pot, I grew up knowing that soup was an integral part of our diet at home. It was rare to have a day when there was no full stockpot on the stove. It was an everyday occurrence to hear my grandma, mom, or aunt insist that Ed and I “drink soup.”

Soup was the antidote to everything. You ate too much fried food? Drink soup. You aren’t feeling well? Drink soup. You’re feeling sluggish or tired? Drink soup. Traditional Chinese Medicine (TCM) has a soup or tonic for pretty much anything you can complain about.

I started getting back into thinking about soup more regularly after I gave birth to Kaia in December 2021. My aunt had lovingly sent me ingredients to make a specific Chinese chicken wine soup (雞酒湯 ji jiu tang), which she insisted would nourish my body to recover quickly from childbirth, while also simultaneously helping my body to produce more milk for my baby (debatable, but it was still tasty). Two years ago, I started being more intentional about making soup. And this year, I am trying to make soup even more often. It’s delicious, nourishing, tasty, and given it’s been so cold this winter, who could say no to a hot bowl of soup? Soup rounds out any meal. In China, there is a saying called san cai yi tang (三菜一汤), meaning “three dishes and one soup,” which is a foundational principle of a balanced, home-cooked Chinese meal that is meant to be shared. It’s typically a meat/protein, one vegetable, one tofu/egg/seafood dish, alongside a nutritious soup. The soup type can vary depending on how it complements the other dishes at the table, but more often than not at home, the soup is a very simple broth that is lightly flavored and seasoned.

I made a simple home-style soup today called yuanzi tang (圆子汤), or pork meatball soup. I was inspired to make it because this blog post by Xueci Cheng, a recipe developer I follow, talked about how integral soup was to her family’s meals in Sichuan growing up. It reminded me of how I ate with my family growing up. And similar to me, she also had forgotten how soup was always at the dinner table at home, as she had moved away to Germany, and soup had mostly been forgotten as a thing to have at a meal. So she made this same soup, and she said when her parents made it for them all during their visit to see her in Germany, they immediately said at the first sip once it was finished cooking that it “tasted like home 家的味道.” This soup is really simple. There’s no required broth base, as it’s mostly flavored by the fat and flavor from the pork meatballs you make (though I did use a cup of dashi I happened to have in my fridge). But after I seasoned it, it really did remind me of the simpler, light home-style soups my grandma used to make when I was little.

My paternal grandma passed in 1995. If she were alive today, she’d be 109 going on 110 this September. Her only granddaughter just turned 40 last month — that’s me. I wonder how she’d feel knowing that even 31 years after her death that I still think about her and her cooking often. I wonder if she’d be pleased to know how much of an impact she’s had on my life and the way I view food, cooking, and our shared culture. She never thought cooking was that great of a skill; for her, it was just something she knew and did. It fed her family (and around Lunar New Year, it fed her friends), and that was enough for her. But in these moments when I taste things that remind me of her and her cooking, I do find myself missing her and wishing we could share that same taste together.