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Travel, Food, and Slices of Life


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You DO have time….you have today.

In the past seven years I have really been involved in the local farm-to-table food movement. I urge people to cook from whole foods. They will enjoy the flavor so much more and they can control ingredients, getting away from preservatives that very well could be influencing your health.  But all too many people have the same answer: “I don’t have time to cook.”

Years ago I was ecstatic that my oldest son’s elementary school offered a parenting course when he was in 1st grade. STEP (Systematic Training for Effective Parenting) helped me recognize nonverbal signs when things were heading south in the kids’ behavior or my own response. I learned to stop things from escalating out of control and how to talk in a way that taught and provided discipline instead of punishment. I helped my kids learn to take responsibility for their actions and how to communicate their feelings, especially when their emotions were roiled up. And it seemed to have worked, because even if the three of them are not perfect by any means, they are wonderful active adults contributing to their communities. I have suggested this course or some other to many friends who are frustrated by their children’s behavior, since it really helped us.  But all too many people have the same answer: “I don’t have time for a 10-week seminar, one hour a week.”

Each of us makes choices, many of them, every single day. We decide simple things, like what to eat for breakfast and what to wear. And we decide harder things, like identifying the goal of the day.

Some of us are planners; we think about what we want/need to do and figure out the various ways to achieve that with all their pros and cons. Some of us never plan; we are reactors. We respond to things that go on around us. And much of the time we are surprised and maybe a little bit (or more) angry because things are not always the way we want it.

 

I want to share with you the story of one woman I never got to know until after I moved from West Virginia. Having common friends, her comments on Facebook resonated with me in many ways. A few issues were not in agreement and it was in private conversation that I learned that this woman understood her position. That nothing about her was merely reactive.

Until the shit hit the fan. Already a breast cancer survivor, you would agree with me that that should be all Paige should have had to deal with, but no. Her beloved husband collapsed with a brain aneurysm and she had to explain to their two young daughters that Daddy was never coming home. You might agree with me that that is more than any woman should need to deal with in her life.

Image may contain: 4 people, including Paige Muellerleile

Source: Paige M – too long ago

But no, still more. The cancer was back and fully metastasized throughout her body. Paige, above all else, is a realist. She understands there is not much time left.

Image may contain: 1 person, eating and indoor

source: Paige M December 2017

The pain of knowing she will not see her daughters graduate gets eased for minutes as she makes memories with them. She’s getting things in place, knowing they will be well loved by others to reach their goals, but it is not enough. There is not enough time left.

And then she posted this photo, and I looked at her…..and I see it. Life. In the moment. Participating. Grabbing all of it. Pain. Joy. Achievement. Struggle.

Paige HD

source: Herald Dispatch

So please please please look at your own life. Are you living? Go. Do.     You DO have time….you have today.

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Being Prepared

Graham and I just came back from a short vacation in Puerto Vallarta. Close friends  from our time living in West Virginia have a timeshare there and have been going annually for twenty years.  They’ve invited us before but since Graham was teaching daily then and the timing never meshed with his spring break from Marshall University, we never could schedule it, until now.

Graham is currently teaching one forensic chemistry course for the fall, winter and spring quarters at Western Oregon University. He teaches Wednesday evenings so last week after class we headed to Portland and spent one night in a motel close to the airport. They offer free parking and provide an airport shuttle. That cost us about $20 more than parking in the long term lot and saved us from having to leave home at 4am to catch our southbound flight.  We returned the next Tuesday and so, he will not miss teaching any classes.

It was a short but sweet vacation, valued highly because of time spent with friends who live in Kentucky. We appreciate the ease of communication Facebook and cell phones permit, but nothing is better than to give hugs in person.

Based on my Facebook postings it looks like all we did was eat…and drink. LOL

But I also went prepared with two prescriptions from my allergist. He said he writes them all the time for both Mexico (you must present them in person) and Canada (you can handle the transaction by mail).

I want to explain the reason I travelled with the hopes of purchasing two medicines and then tell you about the experience.

When we first moved to Oregon, my health insurance was part of Graham’s retirement package. It moved me from PEIA (if you have been following the news recently you know West Virginia teachers went on strike to win a 5% raise and no change in their health insurance rate from PEIA. The state had offered a 1% salary raise which was more than negated by a higher increase in the employee share in the health insurance premium. I am so pleased that it took teachers in all 55 counties to stand strong to win this concession from the state legislature but the issue is still not over…more wrestling ahead…but this blog is not about that fight. Just suffice it to say that West Virginia schools are severely underfunded while people in power issue themselves plenty of perks. Seems to be the culture these days throughout the country.)

Okay, back to my story. My health insurance was with a national company and worked fine. It cost me about $500 a month.  Then the ACA passed its Supreme Court test for the mandate that EVERYONE must buy health insurance and I switched over. My insurance premium cost me $550.  That was based on the prior year’s income and of course, Graham had retired and our income was significantly reduced. I appealed for a reduced premium and in their infinite wisdom I was moved to Oregon’s Medicaid expansion, the Oregon Health Plan.

I was initially concerned because I assumed that the healthcare I received would be of lesser quality but with the exception of only one questionable doctor visit,  I was very pleased. The clinic was prompt, the staff was very friendly, and the doctor usually spent at least 30 minutes with me, or longer if needed.

I rolled through that system for 18 months but at the next renewal the questions changed and I got bumped out. Back to the ACA. My new premium was $462 a month BUT it would not start coverage until January 1st. My OHP plan ended September 30th.  That left me three months without any insurance.

I pleaded with each organization to let me stay longer or to pick me up sooner but was told no. I have found out since them I should have called the state insurance commission and it would have continued the OHP the three months. Remember that if it ever happens to you.

What it meant to me was I needed to pay cash for my prescriptions. The blood pressure medication was not bad ($60) but my two prescriptions that help me breathe were close to $1000. Per month.  Simply, we could not afford that.

I picked up my medications the first work day in January and went to the allergist (after I got a referral) about 3 weeks later. My lung function was measured at 37%.

Two months later, back on daily meds, it was up in the high 70s.  In other words, I need this medicine to live.  Each time Congress plays around with dismantling the ACA I know I can expect to die.  I understand I am not alone. I do not generally join in with conspiracy theories, but it is easy to believe “they” want “us” to die.

So flash forward to my friends’ invitation to join them in Puerto Vallarta and our pre-trip discussion about what we want to do etc.  She mentioned that the farmacias there have medicines at much lower prices than here. Hence, the request and issuance of those prescriptions for my breathing.

They had one of the medicines I needed at the pharmacy we visited the last evening we were there. (Yes, I should have started this part earlier but……) I was able to purchase the medicine that helps my lung function, Symbicort. IMG_3171

The cash cost for the Symbicort here is between $400-$450, even with discounts. The cash cost for the same amount of medicine in Mexico was $80. IMG_3172

The packaging is different, but sometimes when I get my prescriptions refilled here the new bottle has a sticker telling me the pill may look different from what I have been issued before but it is the same.  So, the issue is not uncommon.

This is a first person example of how we pay so much more for our medicine than other countries.  You’ve probably seen charts before like this one.oxycontin_0

Some people argue that we are paying for the pharmaceutical companies to do their research. But recently some of those corporations have announced they will no longer do research for medications to help with  AIDS, Parkinson’s disease and more.

Some people argue that we are paying higher prices to subsidize the rest of the world.  Really?  Not true. Other countries have negotiated prices with drug companies for their health insurance programs.

I believe we are charged what they think we will pay. Simple as that.  And so, many people are either not taking the medications they need to be in good health or they are finding other ways to cope.

The problem is, many of us can not afford jacked up prices, like insulin that increased 197% from 2002 and 2013. Or how the cost of an epi pen went up from  $100 in 2009 to $600 in 2016 (400%)and the CEO of that company is well known for his smirk.  Thank goodness there are generic alternatives. 160826143616-mylan-epipen-exlarge-169

Bottom line: there is a lot wrong with our healthcare system and what we pay for it. Our premiums increase annually, our service plans decrease and the insurance companies and pharmaceutical companies are experiencing record profits.

Why is health care not considered a public service industry similar to water, sewage treatment, electric/gas/whatever you use for heating and cooking?

Until we fix our issues here in the United States, Mexico and Canada will continue to reap the benefits of attracting savvy  medical shoppers.

 


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What does “pink slime” have to do with whether beef broth “gels”?

I’m so fortunate that I know so many wonderful farmers who do what I can not do: grow food. And so many of them, like Chrissie Zaerpoor of Kookoolan Farms of Yamhill, Oregon,  have a very high goal to make sure the food they produce for themselves and the public is healthy and free from additives. Chrissie wrote this blog about pink slime after she got a lot of questions why her beef broth had a gelatinous state when cold.
chicken stock2

The ideal stock is made from a combination of meaty bones for flavor, connective tissue (tendons, cartilage, heads, feet, etc) for gelatin and texture, and hard bones for minerals (primarily calcium but others as well). A well-balanced stock made from good quality ingredients should always “gel” at refrigerator temperatures.

Many of you already know that I came to beef quite late in life: I was a near-vegetarian for my first 40 years with maybe five lifetime total servings of red meat. When I was diagnosed as profoundly anemic, and several years of iron pills and green vegetables did not bring my iron levels up, I was finally ready to take the plunge for eating red meat. But the more I read about commodity red meat, the less willing I was to eat it. This finally erupted in the famous temper tantrum that launched Kookoolan Farms: “if I want to eat grassfed beef, I’m just going to have to learn to do it myself.” I’ve been reading about the commodity meat industry for more than 15 years, and every year I think I’ve finally learned all its dirty secrets, but every year I learn a little more and am saddened to discover that it really is just a little worse than I thought it was. This week an off comment in a news story in “The Week” magazine got us off on a research tangent, and I learned more about “pink slime” than I had previously known – including a key “a-ha” moment with the answer to the question so many of you have asked me over the years: “Why doesn’t premade broth or stock gel? It always gels up with no problem when I make it from Kookoolan Farms bones. What’s the difference?” Now I know…. read on. (for the full details you can easily pull up the Wikipedia article about pink slime).

For starters, the formal name for “pink slime” is Lean Finely Textured Beef, or LFTB. It’s interesting to note off the bat that this highly processed beef derivative is “approved for limited human consumption” in the U.S., but is completely banned both in the European Union and in Canada. In March 2012 (interestingly, the latest date for which I could find data) more than 70% of all ground beef sold in the U.S. contained the additive. Also interesting: ground beef can contain up to 15% LFTB with no labelling required to announce its presence. In fact, the only way to avoid LFTB in grocery store ground beef is to buy USDA certified organic, in which LFTB is disallowed.

wiki pink slime

Lean Finely-Textured Beef, AKA “pink slime,” photo from Wikipedia. 95% lean. All indications are that there are no food safety issues associated with this highly-processed “salvage” product, which means _it’s never labelled as an ingredient_ on any products you buy.

So what is LFTB? It’s the very last scraps of meat and connective tissue still clinging to the bones and hides after a skilled butcher has already removed all of the usable meat with a knife. Some of these source areas are considered to be the areas most likely to be contaminated by pathogenic bacteria. These “source materials” are then warmed to about body temperature in order to soften fats and connective tissues. Originally the bones were scraped and rubbed to remove the last bits of clinging muscle, but the resultant product was up to 20% calcium and therefore “not nutritionally equivalent to beef.” At that point the method changed, and now most LFTB is produced by centrifuging. The centrifuging also separates the fat from the lean in exactly the same way that centrifuging separates, say, heavy cream from skim milk. So the resultant product is around 95% lean (i.e. 5% fat). Having been processed at body temperature, the presence of pathogenic bacteria is now considered a given, so the product is exposed to ammonia gas to weaken the cell walls, and then the product is rolled out thinly and flash frozen under high pressure, crushing all the pathogen cells. This crushing both kills any bacteria and also results in very little structural integrity for the muscle cells, hence the “finely textured” nature of the product. The product is then extruded as a pale pink paste through slender tubes, frozen, and shipped to meat processors as an additive. The ammonia-gas-and-crush process is so effective at killing bacteria that in 2007 the USDA declared that the process would be “exempt from routine testing of meat used in hamburger and sold to the general public.”

Why do meat processors produce and use LFTB? In a word, profit. This is a way to squeeze literally every last gram of flesh off the bones. Also, because it is so lean, LFTB is used as an additive in ground beef to raise the lean percentage: consumers are willing to pay a premium for leaner ground beef, and using 97% lean LFTB in a mix allows the less expensive fatty ground beef, mixed with the extremely lean and extremely cheap LFBT, to then be sold as higher-priced lean ground beef. Up to 15% LFTB is allowed, and there is no labelling requirement.

You’ll also find LFBT in beef hotdogs, beef pepperoni, meatballs, summer sausages, and superthin beef lunch meats and bologna, where LFBT may comprise up to 25% of the total product — but it will never be labelled as such.

You’ve likely read the staggering claim that one patty of ground beef may contain the DNA of more than a thousand cattle from more than 10 different countries. THIS is how that happens. And when you read about recalls of millions of pounds of ground beef, it’s because one animal’s scraps get spread so widely into the food net.

beef hotdogs

Hot dogs may taste good, but did you ever think about what it means that they are “highly processed”?

Interestingly, one of the USDA’s senior food safety inspectors dissented on the USDA’s ruling that LFTB can still be called “meat.” He argued vigorously that LFTB is not “meat” because it also contains connective tissues such as tendons and cartilage, and further stated in reports that it is “not meat,” but actually “salvage,” and should not be allowed for human consumption. The USDA never tested independently for food safety, but the largest corporate producer of LFTB, BPI Corporation, commissioned a study from Iowa State University that found no safety concerns. Because the entity most benefitting from this result also paid for the study, one can doubt whether it’s a truly independent research.

Does it matter that commodity ground beef almost certainly contains LFBT? Maybe not. Associated Press food editor and cookbook author J.M. Hirsh compared the taste of two burgers: one with LFTB and one without. He described the LFTB-containing burgers as smelling the same, but being less juicy and with less flavor. To my knowledge no food safety incident has ever occurred due to the presence of pink slime, but you just can’t be sure whether the recalls have been ultimately caused by LFTB because it’s not tested, and it’s not labelled.

Ammonia is present in many other processed foods, as the BPI (Beef Products Incorporated) web site defensively points out: the finished ground beef contains 200 ppm ammonia, compared to 440 ppm for the bun and 813 ppm for the cheese. In other words, these chemicals are already in lots of other processed foods, and are assumed safe, and therefore are not required to be labelled because “you don’t need to know.” That, my friend, is just one of many similar decisions made every day on your behalf and without your input. Here is the USDA’s fact sheet on LFTB.

stock pots on the stove

Beef bones from Kookoolan Farms have “stuff” still on them, never cleaned by centrifuge. Those bits of tendon, cartilage, and other connective tissues give you the silky, velvety, gelatinous texture you expect from homemade beef stock.

Meanwhile, bringing this back around to stocks and broths, the “gelling” process that occurs when you make stocks and broths is due to the presence of scraps of connective tissues and collagen still clinging to the bones. When you buy pre-made stocks and broths in a can or box or in the frozen aisle, one assumes that these are generally made from the cheapest available ingredients. The lowest common denominator of commodity beef bones, even those from grassfed beef, would generally speaking now be so clean (thanks to centrifuging) that there is no connective tissue left on the bones. Thus purchased stock does not gel. Maybe that’s why they add so much salt, too: store-bought just doesn’t have as much flavor as homemade. Last week I observed organic grassfed beef stock in the freezer section for Fred Meyer for a shocking $12/quart. Are people actually buying that rather than making their own higher-quality stock FOR FREE?

Kookoolan Farms beeves are hand-processed using only skilled butchers and knives, no high-tech centrifuging machines, no bleach, no ammonia gas, no LFTB, no strange gasses in the packages to preserve color, nothing but beef. The meat in your share all comes from identically one animal. And your soup bones are hand-cleaned with a knife, leaving plenty of good “stuff” on the bones to give you a rich, gelatinous, natural stock. As always, you may get bones, fat, and organ meats with your beef share at your option, and at no extra charge. Those grass-fed beef bones sell for $3.50/lb and more in the grocery store, but you’ll never pay extra for them from Kookoolan Farms.


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Almost Normal

Almost normal! It’s been about 5.5 weeks since my total knee replacement December 4 and I will see the surgeon on Monday for a post-op appointment. I have some expectations and hopes for that visit. The primary issue is will I get permission to get back into our hot tub?

We purchased an inflatable hot tub almost 2 years ago. We discovered how helpful sitting in the hot tub could be back in 2007 when Graham was on sabbatical in Pueblo, Colorado and the apartment complex had a hot tub next to the pool. We learned that the heat eased sore muscles and joints and improved nighttime relaxation and better sleeping  Although we were in Colorado from January 1 through June 30, the hot tub was available, even in the winter when the pool was closed. It was about 200 yards from our apartment door. We’d get into our bathing suits, put on our terry cloth bathrobes and some slippers and walk over. Chilly, but bearable. Getting out and back into the warm apartment after the soak was more of a challenge. I discovered that there seemed to be an envelope of warm air around my body for a very short time when I exited the hot tub. Getting the bathrobe on during that time was mandatory! Then put the cover back on the hot tub and high tail it back inside.

hot tub

Our apartment was in the building on the right side, so not too far, except when it was 5 degrees.

hot tub in WV

The photo viewpoint is from the kitchen door, so you see how much shorter the after-tub commute became.

We agreed if we ever should be lucky enough to have a hot tub it would be right by the door to the house. And so, about a year later, we found ourselves building an enclosed screen porch on the back of our house in West Virginia. The tub sat on a concrete pad on the ground and the floor of the porch was built around the tub. We stepped down into the spa and Graham installed a handicap pull bar to help any of us to climb back up and out. The walk to the kitchen door was maybe 10 feet, very easy even in the winter.

But then we moved to Oregon where we are renting a house. I was missing the evening soak time. My joints ached more and so, a friend suggested an inflatable. We bought a Coleman hot tub for about $450 the first year but after they replaced one filter/motor, when that failed within a few months, they would not replace it. We searched but could not purchase a new filter alone. So we bought another inflatable for about $250. Watch for sales!!IMG_1953

The inflatable works for us. It runs on 110 household current so we did not have to install a new 220 line into the house. That saved us some money but the lower wattage means the temperature control goes through a cycle which runs about 48 hours and then turns off. We need to check and restart sometimes before the shutdown happens so we can maintain the temperature. The other issue is that it will not run the heat if the jets are operating. Not a biggie for me; I don’t use the jets.

So, the last time I was in the hot tub was the morning before my knee surgery. After that I was restricted from “swimming, hot tubs, saunas” and a few other wet activities. One concern is infection through the suture site. That is well healed now, so should no  longer be a factor.

But, and this is a big issue, I need to be able to get myself out of the hot tub safely. First, I need to be able to swing my leg over the height of the wall. It is an inflatable so not rigid, and if I touch it, it will bend. Graham built me a contraption with 2 posts and a rope so I had something the proper height for practice.  That was not difficult to gain the movement I needed.

Image result for block and tackle to lift heavyHowever, I need to get up off my butt. The inflatable hot tub does not have the molded seats a regular fiberglass hot tub offers; we sit on the padded bottom. So, I need to be able to stand up without the need for a block and tackle.  Simple, eh?  Well, no. As my knee issue got worse and started involving my pelvis and hips last summer, Graham installed a handicapped handrail on the post holding the roof over the tub. (You thought we sit in the hot water with the cold winter rain falling on us????? Come on!)  That rail helped me, but I was able to get on my knees before the surgery. Now, not a comfortable position.  So, after thinking and thinking about it, I tried a few times at home.

Now, in order to do a task that is difficult, the easiest way to figure out how to manage the move is to figure out the physics of it to maximize the strength while minimizing effort. I didn’t take physics in high school and until now, I figured the computer science class I took instead was an excellent substitute.  But now,  more than 45 years after that class decision in high school,  I was trying to figure how to fulcrum me up and out…..hmmmmm

Physical therapists are special people. Maybe a tad masochistic as they push their patients through pain to improvement, generally they are upbeat, optimistic and very much enjoy challenges like this. So this morning at Physical Therapy I sat on the floor next to a table that had been lowered to the height I needed and it only took two times to conquer the move. I know I can get up now! No block and tackle needs to be ordered. LOL

On Monday I will go to the surgeon’s appointment prepared to show him I have the safety issue covered. And if I need to wait, I will wait……but I am betting on hot tub Monday evening!!!

 

 


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The Magic of Having Cheerleaders

On Monday, December 4, 2017 my right knee went missing.  It had provided 63 years of walking, hiking, skiing, whatevering and it was not functioning as it should because of damage caused by a fall and by illness. The knee was replaced with a modern medical miracle, one that has become so hohum that you probably know at least five people who have had knee replacements.

It really helped to talk to all those people prior to my surgery, to hear their advice and learn of tricks they used. The one thing I heard over and over and over was “do the exercises”.  One other comment, made quietly, also was handy, “You will not always get to the bathroom on time.”

When I’ve gone through SOMETHING, whether it is a physical activity like this surgery, or an emotional voyage, like a divorce, it can be very helpful to hear first person experiences. It has let me know that what I was feeling was pretty typical….or not.

It was during one of those discussions with a friend that the idea of an allergy to the implant hit me! I can’t wear pierced earrings of any kind. Sterling silver, 24k gold, surgical steel, platinum, titanium, even plastic coated, all have caused my ears to start itching and I end up removing the earrings within 15 minutes.  So, I read and then I talked to the surgeon at the pre-op appointment and I am wearing low-nickel metal with ceramic and plastic pieces. All fingers and toes crossed.

The first few days after the surgery was spent discovering that the pain meds and I do not get along. This experience made it very clear to me just how different our body chemistries are. I was nauseated and just felt overall horrible.  I had none of the “highs” users addicted to oxycontin enjoy. They obviously do not experience all the “yuks” I had or they would move on to some other drug of choice.  (This lightbulb moment made me realize that “addiction” is a horrible thing and we need a multi-prong attack to help people get off the drugs but also help them learn coping mechanisms for the issues in life that have made them (all of us to some extent) reach for help after a hard day.)

Once we moved me down a notch in the pain medical pharmacopeia, my overall body feelings were healthier and I could get on with the business of healing.

One thing that has made this experience easier is the time people have taken to drive me to my appointments (Graham can’t drive because he is legally blind), take him to the grocery store, run to the drug store for the replacement pain medicine, and just those who stop in for a few minutes with a smile to help distract me from focusing on the knee which is yelling “OW” most of the time.

And then, there is the physical therapist. Most knee patients have love-hate relationships with the love coming much later in the time table. Mine earned it on Day One when he exclaimed enthusiastically how well I was doing. He was so effusive that I started tearing up.  “No,” he said, “It’s good, really!”

So, I explained. Anyone who knows me knows “body perfect” is not now nor has ever been a goal of mine. I try to eat healthy food and not overindulge with the “fun” things but taking the time others do to firm up and have their body parts move better has not been my thing.

Here I am, 63-years-old, and this is the SECOND time in my life where I experienced BODY PRIDE. The first was after my first baby was born and I was able to nurse him. The idea that this body had produced that miracle and could sustain it nutritionally. Amazingly powerful feeling.

And now, in pain and hobbling, I am ahead of benchmarks. Me….the “couch potato” (well, maybe desk sitter is more like it). knee day 6

Altogether, the friends giving their time and sharing their good wishes and this professional who sees a lot of people like me are my cheerleaders. They have assumed the role to help me get better. And while their time investment may only 30 minutes or a couple of hours a week, they are a component in my healing that will no doubt get me to the finish line easier.

So, thank you, each of you, who send a joke, a funny picture, a phone call, a visit, a drive in the car. To all of you who are my cheerleaders, I salute you.

 

 


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It’s a Puzzlement

Sorry for mixing my Broadway musical metaphors but I need your two cents because, like Tevye, I’m getting a lot of On The Other Hand  in my decision making.

Back in January I wrote about my experience with six decades of wading through medical care with all its various changes.  (I wrote that blog to help people who might not understand why the ACA is so important to people who have difficulty obtaining health care that can be within financial reach. Many of the comments I received were that people were sad I had gone through all that. The point was, many many many people do.)  And even as I wrote of all my issues, that was before my left hip started protesting loudly the year plus of walking “wonky” with my bad right knee. After a gait adjusted for pain, my pelvis had tilted. It wasn’t enough to juggle the stupid knee and then the cornea transplant, I had a new medical issue that provided a new education. Lucky me.

The increased level of pain led me to think I would have to close my business, Can-Do Real Food, My logic said that was the right decision. My emotions were not in agreement. (You can see how Tevye’s dilemma discussion seems to be part of my DNA, or at least cultural norm.) fiddler

My regular doctor offered me pain pills.  While I filled the prescription for the muscle relaxant, I soon discovered not only did it not work, but neither could I with a muddy head. I decided to go outside of standard medical practice and found a chiropractor who might help move that pelvis back into alignment.  Between his gentle pokes and prods as well as physical therapy inside his office environment, the screaming pain has diminished and I can see a glimmer of dim light ahead.

But then I ran out of insurance benefits.

The chiropractor reminded me it had taken me a year to get into the twisted position and it would take a while longer to get out of it. His thinking was once I got that part aligned I would be functional and need only pop back in to see him when I realized I was hurting again.

But I can’t afford him.

So, back to my primary care doctor who offered to send me to the same doc who said my original injury to my knee in June 2016 was “only arthritis” and “I would never need surgery”, all without the benefit of a scan. I told my primary doc I would not go back to him. I expect my doctors to base their advice on information and avoid those who don’t.

Also, since I’ve been hearing I have arthritis for years now and the pain is increasing in the affected joints, I asked to speak to someone with arthritis expertise to give me advice.  Turns out that specialization is a rhemolotolgist and the first clinic said I was not bad enough to take up their time and the second clinic gave me their first available appointment four months from now. Since I don’t have rheumatoid arthritis it is perhaps not a needed visit anyway, but it sure would be nice to get some better info.

Yesterday I had an appointment with a new orthopedic doc. I went in wanting info, very much convinced I am not a surgical candidate nor is my knee hurting that badly right now so why would I want surgery?

He convinced me I need to have the surgery.  The pelvis will NEVER be right until I am walking more normally. My knee will never be better and will only get worse. I wanted to know the probably progression of the deterioration and he was able to take the time and explain it.

So, straddling the conventional/nontraditional medicine routes gets sticky when I opt to lean one way or the other; the other side of my care spectrum voices their concerns. Some are valid. Some may be self-serving.

Here are the issues of my dilemma:

  • My insurance will be changing. I have received notice that the plan I currently have is not going to be offered. The next “best” plan not only will cost me almost $300 a month more, but will not provide for any “out of network” benefits. Since I am not always only in my town, I understand that  even a day trip to the Coast with some level of accident could end up bankrupting me. So this next “best” option is not viable. I have an appointment with an insurance navigator next week when the markets open, so we will see what we will see then.
  • Since my insurance will be changing, any additional help beyond the immediate post-operative period by this new doctor may be a financial hardship. Do I wait to chose a new orthopedic doctor after my insurance changes, pushing me into a later calendar schedule for the surgery and recovery during my busy season with Can-Do Real Food (no, I’m not closing the business). Or do I just hope he is “in network”? Or do I just hope I can switch to another ortho doc who is “in network”?
  • Will I even be able to afford any health insurance plan next year? Since Trump has eliminated the subsidies, that means my health insurance premium will most likely take up 60% of my social security payment. That is before I actually go to the doctor and pay my co-pay and pay for all the medicines I need for my asthma and blood pressure. How can I afford this?

And then, on the nontraditional side,

  • I learned on my trip to New England that the CBD portion of marijuana does an extremely effective job of reducing my pain without making my head affected. (It amazes me how many conventional medical people I have spoken with HERE IN OREGON seem not to know anything about the usefulness of this herb. But here, have some oxy. The restrictions by the Federal government have muzzled them at best and stunted their education at worst.)
  • My knee pain is very tolerable right now. My hip/pelvis problem is moving in the right direction. I can still get more physical therapy and of course I have the exercises to do at home.  If I do them…..but that’s another issue.

The new ortho doc said something that sounds real: “Many people opt to wait because they are not feeling “that bad”.  And then something happens and they are in horrible pain, wanting the surgery and then needing to wait a month or two to fit into the schedule.”

And he also said “Most likely you will heal better and faster than someone who is in high pain prior to the surgery because you are still pretty mobile.”

We have mundane but real issues also.

  • I will be restricted from driving, of course, for a while. Typical is 6 weeks but it could be shorter if I can comfortably and in good time move my right foot from the accelerator to the brake sooner. Graham, being legally blind, can not drive. So while we are going into our quiet season with the business, there are normal things we do: grocery shopping for example. Also Graham teaches one forensic chemistry class each week at Western Oregon University, about 40 minutes south of where we live.  So, we will need driving help.  We have many good friends who offered with my eye surgery and that was only needed for two days, so we haven’t abused them too much yet.
  • Sleeping spaces. The master bedroom is upstairs. I have been sleeping in the guest room, a room too small to transition permanently into the master bedroom, for months now, only climbing the stairs when we have overnight guests.  Following this surgery any guests will get the master upstairs. That part was easy enough to figure out. LOL

So, like the King of Siam, it is a puzzlement to me. A time of change is upon me. A decision needs to be made that will have consequences. Those issues, with the exception of the health insurance costs, are not easily quantifiable.options

 

 

 


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I Did Okay

About thirty years ago I had an epiphany. My job was not the activity I did that provided income. My job, it hit me, was to raise those little munchkins I had birthed to become healthy and happy adults who could function as contributing members of society.

It wasn’t an easy road, as anyone who has walked it can attest. Having a spouse who had a completely different parenting philosophy was harder, believe it or not, than when I was a single mom.  But trying to parent alone can be a constant struggle against fatigue and a slippage of consistency.

I’m not a deep analytical thinker generally but as a kid, whenever I chafed at the rules and restrictions imposed by my parents that seemed unfair, I thought about why. What was the purpose of the rule?  Was it fair? Could my parents have achieved my compliance more readily if they had presented the need for a certain behavior a different way?  It seemed to me that the answer was yes, life was unfair to me then. easier to build a child

I knew my parents, overall, were okay. I understand better now that they had their own issues and that they did what they thought was the best thing for my sisters and me. And despite some developmental restrictions I had to learn to overcome as an adult (i.e, how to deal with anger in a way where it would not blow up into World War III) they gave me a lot of experiences that many other kids don’t get.

Our family was in no way child centric, but my parents were involved in activities that provided for my exploration and growth. Scouting, encouraging my love of reading, camping and travelling, helping us learn to swim, and PTA were things they did. There were inconsistencies about religious training and practice which I now recognize was a struggle between the way my dad and mom had each been raised. They encouraged my participation in the music education program starting in 4th grade, something I did with my kids and learned quickly to appreciate that my parents had provided that model.

What’s fascinating is that when I discuss memories and issues with my two sisters, their experiences sometimes were considerably different from mine. If that can happen in the same environment, the whole nurture vs nature concept shows up more clearly.genetics-nature-vs-nurture-4-638

Looking back it is easy to see that each of my kid’s personalities was evident right from the beginning.  They were who they are even as infants and toddlers. The way they expressed themselves, their willingness to explore or need to stay close, and their responses to me were challenging and wonderful and scary, all at the same time.  I recognized that this was my biggest responsibility in life and I knew I wanted to give them something better than I had had.

STEPI knew I wanted to parent differently but also knew that unless I made an effort to learn a new way, the guidance I heard in my head and heart would be the way I had been raised. I was fortunate that my older two kids attended an elementary school in  the “poor” neighborhood of a town in Connecticut where education was held in high esteem. (in other words, we paid higher taxes for the school system there than any other place I have lived.) The principal of the elementary school was a consummate grant writer and we had an amazing array of programs, offered free. One was a parenting class called Systematic Training for Effective Parenting.  While child raising practices have moved on, this served as an amazing framework for me to teach my kids about fair communication, accepting responsibility, and understanding that there will be consequences for misbehavior.  One of the best parts, particularly after a year or two of practice, was that we all had fewer angry meltdowns.  Me too.

I know it would be interesting to read their perspective of the experience. Now adults in their 20s and 30s, I suspect I would hear about all the horrible things I did to them. But I also think there would be many more positive issues. (I recognize that statement might be self serving. LOL)

I just came back from a long weekend to celebrate my youngest’s 23rd birthday. The joy I felt was better than any drug. I could easily see that despite a pathway taken that was not the original planned, he is doing fine. He is healthy. He is supporting himself (well, almost). He has good friends who also are finding their way along their own pathways.

One important difference, I think, between my parents and me is that I do not expect my kids to live their life the way I would if I had their opportunities.  This son struggled in school, a surprise to all of us. Yet in today’s economic turmoil, a college education is not proving to be the answer it was to my generation, so understanding there are other ways to earn the money to live is part of my letting go.  After all, earning a living is NOT the same as building a fulfilling life. My hope for this young man is the same as it was when he was born and he is well on his way to being the healthy, happy, functioning adult I tried to aim for with my parenting.