goingplaceslivinglife

Travel, Food, and Slices of Life


Leave a comment

When the Family Fails

I want to share a story while providing some sense of privacy for the people who are at the center of this tale…..they are human like the rest of us. Like the rest of us, the choices they have made and continue to make seem to serve them but they are not happy people, so perhaps even they realize something is very wrong with their life path.

My birth family had its issues. My parents were very close, at times to the exclusion of my sisters and me. See, mom was not healthy. I have no idea what her diagnosis would have been but each of us kids have had our adult issues because what we were TOLD and what we OBSERVED were two different things.

My parents did a lot of good things for us that, for me, offset the negatives a lot. They took us camping around the United States. They encouraged us to learn musical instruments and we were all active in Girl Scouts. We received our religious education and while we did not go to Temple each Friday or Saturday, we went enough for me to understand my heritage and that doing good deeds was a part of making a good life.

But I always knew some of the things mom said were not based in the reality where I was living. I spent a few years in my early adulthood breaking many of those “rules”, proving my life would be just fine even if I rebelled.  I stumbled, and I picked myself up and I learned very quickly that no one, not even my parents would ever ever rescue me.

My sisters and I have compared notes over the years and they did not have the same perception I did. The rules were the rules and there was a lot of guilt over breaking them.  We had failed marriages. We had addictions. We grew through them and beyond them. We still probably continue to stumble sometimes but we have never ever said “stay away from me” because we are family.

dysfunctional-family

source: Lucky Otters Haven

Meanwhile, around us are a kazillion other families, each trying in their own way to do the right thing with their kids. But we know our society has been failing. We have kids who are out of control. Adults now, they want what they want when they want it. They don’t know how to plan for a goal and deferred gratification is a concept that they never learned.

Many adults were not taught life skills by their parents and do not know how to cook a healthy meal. How to plan a budget. How to get along.  How to TRY to get along. They feel what they feel and everyone else who feels differently is wrong wrong wrong. Even sick and maybe should be hospitalized.  Attack and deflect if you can’t get along…..make it the other person’s fault and never never assume any responsibility.

And it goes to the parents….and then to those adult children who continue the cycle by striking out at anyone who ruffles the waters, who disturbs the system that holds the status quo together.

Image result for shutting the door in someone's faceI have a friend I met over 20 years ago who needed a place when her family told her “don’t come here” and so, she came to me. Now, I know with my own mother, most people looking at our family never imagined we had anything less than “happy” going on behind our doors, but that’s the way it was. So I can imagine that it is hard for a 50-70 year history of aggravation to be set aside to rise and be a family, especially when there is a strong person in charge. Even if she is not healthy.  Especially if she is not healthy.

I understand how hard it is to confront an irrational person, even when it is apparent to all around her that things are not right. Weak people tend to hide. They do not want to be the next target.  So they are compliant and accept the way it is, and anyone who tells them otherwise, like me and this blog, is wrong.

Too many people would rather sweep issues that are difficult under the carpet in the attempt to ignore them. Too many people come on aggressively when they feel a horrible conflict with what they “should” do and what they “must” do.

And so, we see homeless people. We see people on drugs trying to make their world calmer, less scary.

When all they need is love and acceptance.

I know they will read this. I know it will not help calm the waters, but you know what, NOTHING I do would help. The only change that could happen has to be from them.

There will be tears. There will be anger. And you know what, it just is more of the same. A pattern that has gone on for over 70 years. People educated in psychiatry would be quick to tell me this blog is not wise.

But it is time for someone to speak up. Before more families do this to each other.  Maybe someone somewhere will recognize that they need some meds or counseling or something to heal the pain that grew. Image result for love and acceptanceMaybe……I hope so.

 

Advertisements


Leave a comment

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.


3 Comments

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.

 


5 Comments

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.

 

 


2 Comments

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

 

 

 


1 Comment

Learning Along The Pathway

When I was growing up my Dad would often drive into town and pick up the Sunday New York Times. As I got older I enjoyed reading not only the magazine but I started perusing the classified, looking for my “someday” job and apartment. Oh, the dreams I had of what could be……and then life took another pathway.

I’ve had a checkered past. I earned a degree in geography and urban planning, but  my first job out of college was for the Tennessee Supreme Court in the court administrator’s office. They were starting a judicial PLANNING division and so, since I had a degree in urban PLANNING, I was hired. It was fun but as I realized I was getting further from my education, I looked for and moved to the planning job.  For three and a half years I actually worked for a planning and engineering company and really enjoyed it. But again……life took another pathway.

There was a death in my husband’s family. His mother asked us to move to Connecticut to take care of the estate issues. We lived in the house rent free and would until it was sold. One of my tasks was to determine the market value of the property and in doing so, we listed it for sale and boom! we needed to move within a couple of months. I was looking for work as a planner but we were in the middle of a recession then and jobs were scarce. So… life took another pathway.

I started working as an real estate agent for the broker who had listed the house. While I did well, I didn’t particularly enjoy it. Showing houses was a challenge because I did not know the area well and there were no apps with a talking GPS (hey, no cell phones at all)  in those days so I had to rely on paper maps, all the time portraying an image of competence to the buyers.  That was stressful enough but the part that made me more uncomfortable was listening to a homeowner extol the cost of the renovations he had made when it looked like a piece of incompetent amateur construction.  And then Baby #1 was born and I no longer wanted to put in the long hours needed in that kind of sales position.  Once again…. life took another pathway.

 

When I told the broker I was going to let my sales license go he persuaded me to start an appraisal division of his company. I built the reputation and business started coming in nicely and then I needed to hire some staff. The broker told me he was moving to California and was selling the real estate business, including the appraisal division. I said no way, it may be your name but it was my blood, sweat and tears. He very much understood and so, I soon owned it. I got a partner who had the bookkeeping kind of background and so we went on, growing during the 1980s real estate boom to 12 employees. (Although I planned longer, I only was able to take off one week when Baby #2 was born.) And then there was another blip in the financial market and property values started to decline. Where there is no room for a second mortgage or a current home value did not support getting the mortgage refinanced, there are no appraisals. We closed the business and…… life took another pathway.

By this time I had had baby #3 and no income. My husband got laid off. We ended up moving from Connecticut to Tennessee where I stayed home with the baby. Then my husband was diagnosed with brain cancer and after surgery, radiation and chemo I got a job at Vanderbilt Medical Center, working for one of my husband’s eye doctors. I had looked for a managerial position at Vanderbilt and when HR asked me what salary I wanted I thought about what I had made in the good years in Connecticut and then made a “cost of living” adjustment and said $30,000. They laughed…too high apparently. Anything lower would not help the family so I changed my resume to administration instead and ended up taking that first position as an AA for $18,000. I figured if I was not going to earn enough money I might as well not be in charge of anything. And so….. life took another pathway.Image result for vanderbilt university medical center

After five years of learning eye health jargon, things changed when the doctor in charge left. My position was eliminated but I was not, so HR moved me to another place in the hospital. The boss was, to put it nicely, a challenged individual. I left and move over to the university side of Vanderbilt to the Department of French & Italian. More new things to learn and master. And then my husband died and there I was a widow with a young child. Graham entered my life and I sure made him work to woo both of us. And there I was again….my life took another pathway.

My kiddo and I joined Graham when he went on sabbatical to Colorado for six months. I thought a start together in a neutral location would be good. We made friends and when it looked like he might be offered a job there I started looking for work. I had a sweet sweet double interview with the statewide blood bank and they offered me a position for a beautiful salary. I came home from that interview to be told we were moving back to West Virginia.  Ha ha…guess what….. my life took another pathway.

Looking for work in the Rust Belt was a challenge. I finally was hired as a practice manager for a financial adviser. Since it was a start-up I accepted a lower than desired salary with the promise of bonuses that would boost it to the sky (dream on, eh?). That never happened. After three years of building that business into something sustainable, I asked for a $10,000 raise and he basically countered with 50 cents an hour. I resigned. This time, definitely my choice…..my life took another pathway.

I started to build up my book selling business that I had been running on a small scale for about 12 years to provide additional income. I was able to match that prior salary for the next two years while having the time to also get involved in the farm-to-table movement and helping build The Wild Ramp. All the time, we were planning for my husband to retire when my kiddo left for college and so……my life took another pathway.

We moved to Oregon just about four years ago. I applied to about 50 jobs, making sure each cover letter and each resume was custom tailored to each specific job. I never heard from 46 place, but had four interviews. One had the grace to tell me I was overqualified and they were sure I would be bored and quit. I countered with an comment (I had nothing to lose)  that at this age I would love a job I could do with one hand behind my back. But no job was offered. (Ageism is one more hurdle to getting a job that needs to be fixed.  Date of birth information can no longer be asked, but they can and do asked for education information, including year of graduation. I think you agree, most of us complete high school at age 18, so extrapolation is easy.) So feeling ready to do anything….. life took another pathway.

I took a summer job as a farm hand. Yes, me. I never ate so much ibuprofen in my life but I did it and learned a lot more. In all my effort with The Wild Ramp I had probably visited 100 farms and had heard their stories. Now I got to get a (very small) taste of the life farmers live.  And the experience confirmed something I already suspected: I am not a farmer. But I need my farmers (we all do) and respect them highly. And so, taking a plunge……my life took another pathway.

I started up the commercial food processing business, Can-Do Real Food, to support local farmers by preserving their surplus produce by canning and dehydrating. (This gives the farmer another income, provides consumers a way to have a taste of the local summer harvest any time during the year, and reduces food waste.)  When we moved to Oregon I learned to can, so I had one year of canning at home. Other people have forgotten more than I have learned but it has been a pretty amazing experience. You can read more about it at the Can-Do Real Food blog. 

In the past year I had been dealing with a knee that has been injured but there is nothing surgical that can be done to fix it. It forces me to walk a bit wonky which has now affected my hip joint on the other side. I am in a new world of hurt and so…..I suspect my life is about to take another pathway again.

Through all these years (63 and counting) I have received continual education. The first part is one we all are fed K through  12. The next was the narrowing down of a field of study (college). And since then, through work and seminars and conferences and self teaching, the learning has continued and increased.  I urge everyone I love to never stop exploring, never be afraid of change.

I know jargon related to the legal profession, the medical profession, the academic profession, and now food processing (and government regulation thereof).  I wonder what’s next!  Whatever it is, I strongly doubt I will ever live in New York City!

 

 


2 Comments

Six Decades of Medical Care

So many changes. Any time you can talk to someone whose life has spanned more decades than your’s, an interesting discussion could result if you asked about big changes they had observed. I thought I’d take you through a small walk about health care as I have experienced it. I suspect this post will be longer than most I write.

doctor-norman-rockwellMy mom trained as a nurse in the 1940s and met a doctor studying to be a pediatrician at the hospital in New York City. When she and my dad moved to New Jersey they were thrilled the doctor had set up practice in the next town and I was told years later that I was his first baby, whatever that implies. Anyway, we would go to his office, located in the first floor of a multi-family house and wait to be called in. I read Highlights magazines and graduated later to Reader Digests. (I guess some things never change.)  I had my first asthma attack at age 5 playing with a hula hoop. I received allergy shots with needles that were sterilized with the glass syringes in the doctor’s office in their autoclave.  When I was too sick to go to his office, he came to our house. The house call that no longer exists.

In college I went to the college infirmary. The health care fee was covered in our overall  tuition which was about $500 a year.  My 19-year-old skiing accident where I banged up my knee was ignored and over a few weeks I healed. I developed arthritis in that knee in my 40s.  (Life lesson…if you get hurt, even if you are young and can heal well, go get help to make sure you are healing correctly.)

My first job after college was for the State of Tennessee in Nashville. I really do not remember the insurance plan provided but it would have been a large group of state employees. I didn’t see the doctor at all except my annual checks for health and I ended up with a minor surgery. I did not take any medication in those days.  I don’t remember the fees but I do remember there was no stress in paying even though I was making about $6,000 a year.

herniated-discI changed jobs and moved to Memphis a few years later and in the course of the move, hurt my back. My new insurance was through my company and even though the injury happened before my first day of work, there was no waiting period.  I saw a chiropractor a few times and then an orthopedic specialist for a year before opting for surgery. There were no MRIs in those days and I was in the hospital for 4 days. My portion of the bill was under $100.  I also started allergy shots again while living there and paid $1 per shot.

I ended up a few years later  in Connecticut. My husband worked and had Blue Cross through his employer. He needed counseling and later a short hospitalization. I started taking blood pressure medication.   We had two babies (one by c-section).  One baby needed a couple of surgeries.  Our copays for medicine were $1. The hospital bills were $500 for the c-section, $300 for the next delivery VBAC, and the other surgeries were about $300 each.

That husband and I split and I was able to pick up coverage for a Kaiser Permanente HMO plan through a small business group. I paid $400 a month for a family plan which included my two kids and me, and later, a new husband.  It had no copays nor prescription costs. I fell and hurt my back again. Again I saw a chiropractor for a while and then he referred me to an orthopedic surgeon. Still no MRI in those days. The hospital stay was 2 days and I think my bill was about $700. I later had a miscarriage and the D&C cost nothing since it was done in the office. My last baby was born in the same hospital as the first, 11 years before but was also a VBAC and cost about $500.

Then I moved back to Nashville and my husband started working for the State of Tennessee and we had HMO plan through Aetna. Prescriptions were $2 or $5 each. Doctor visits to our primary physician were free. Specialists were more and this was when things started getting really interesting since my husband was soon diagnosed with brain cancer.  We were sent for a C-Scan one day and then an MRI the next. The specialist at Vanderbilt Medical Center ran a kazillion tests to determine where the tumor was located and the potential effect removal would have. Surgery was scheduled and became the day my life seriously changed as he had the equivalent of a stroke on the operating table and was not expected to survive. But he made it through the night, improved in fits and starts in 8 weeks in the ICU, another 2 weeks in a regular room and then home. Physical therapy was provided at home for a few sessions and then we went to the clinic for that. I understood the coverage for physical therapy, occupational therapy and speech therapy was for 5 weeks. The clinic suggested visits twice a week. We asked for and went daily every weekday of those 5 weeks.  At that point he had improved enough that they wanted to try the surgery they had had to stop 5 months before. It went well, with 2 weeks in ICU and then home after another week. The bill, when it got to us and I finally figured out the in and out and all around nonsense, was $7500 to us.brain-tumors-fig4ab_large

(Now, we step aside for a minute. Recognizing that $7500 is an amazingly low bill for all the scans and surgeries and special tests and ICU and medicines, it still was something above and beyond what we could afford. He was the wage earner. I was home with the baby, something both of us had wanted to try to do for a couple of years and I was just starting to look for work when his seizures started. So, we had no income, no savings and we had that $7500 bill and of course all our normal living expenses and rent, utilities, food, car expenses and then I needed migraine medications, I’m sure you can understand why.

At that point I did a few things. First, I called our landlord and asked him if he had a smaller, less expensive place for us to live and he listened to the why of the question, was silent and then said “The last thing you need is to move. Pay me when you can as much as you can and don’t worry about it until then. I am in a position to help you.” That man is one of my life angels. I have used this story whenever I hear anyone talk about how people who are homeless are all drug addicts or drunks and basically did it to themselves. There but for the grace of that wonderful man, we would have been homeless.

I also called and talked to someone at the county level to find out if I qualified for any assistance program for the six months until the social security disability payments kicked in. They said no. The problem was we had a VERY few thousand dollars in our IRAs and they wanted us to use that up before any public assistance would kick in. The fact that it was a temporary need and very little set aside for our future did not work into any equation for help.

Finally, I called the credit card companies. We had 3 cards and each had about $2000 on it. I asked for the cards to be frozen. Basically I would not use them but asked for no interest or penalties. I owed the $6000 but did not want to see it go ridiculously higher when we could not make payments. They refused to work with me.)

So, back to the medical care. Cancer is expensive. We had radiation therapy. We had chemotherapy. And then, something unexpected happened. He did not die. I was told to expect him to not live beyond five years and when all was said and done, it was about 10 years. I had gotten a job after the first round of chemo so we would start having more income. I was lucky to get a job at Vanderbilt Medical Center and later the University. In those days the issue of pre-existing conditions meant that he would have had no medical coverage at all and I would not have had coverage for my blood pressure, allergies and stupid migraines for at least 12 months. But the year before the Democratic Congress had passed a law that any employer with more than 100 employees would offer health plans with no pre-existing conditions limitations.

So on we went. The plan each year at Vanderbilt changed. Sometimes it was strongly limited to Vanderbilt with very low fees inside that medical center and higher rates outside. No big deal to us since we were relatively new to town, but it caused messes for people who had relationships with doctors outside the system. One year it was equal inside and outside the medical center. I had sinus surgery that year at a different hospital.  By that time my share of our medical bills were topping $15,000. Still not a ridiculously high price but too high for us.

I went to talk to a debt counselor. After hearing my story he got up and shut the door and said they were not supposed to suggest bankruptcy but our situation was exactly the reason the law was there. I refused. Maybe not my wisest decision but I felt we owed all we owed except for the stupid interest and penalties for the three credit cards. He suggested if I chose bankruptcy my credit would be okay in seven years. I still said no. I felt morally obligated to pay my bills. I just needed help getting them reduced or a time payment plan set up.bankruptcy-causes

hospicemedallionAnd on it went. About eight and a half years into the illness my husband could no longer stay home safely by himself. The option of me quitting working was not feasible, so we needed to find a nursing home for his care. The one that had a bed at the time was my third choice. The top two had a medical director that was our primary care physician so I thought the continuity with the same practitioner would be beneficial. But they had no beds, so he went to #3.  It was fine, as those kind of places go, but week after week he “failed” the test to be able to become a Medicaid patient. He could put the pills in his mouth and swallow them when they were handed to him. He could dress himself in two hours when the clothes were given to him. He could still manage to shuffle to the bathroom. But the time came when he couldn’t do enough of the things on the checklist and so, became eligible. All bills were sent to Medicaid. The nursing home had a fire three days later and 13 patients died. (The story of that night is for another time.)  Ironically, my husband got transferred to one of the places we wanted.   Once Medicaid took over, I had no more additional costs for him. We stopped taking him for MRIs when it needed to be by ambulance and really, why bother after a while. Hospice got involved and visited him three times a week to provide supplemental care issues.

I stayed at Vanderbilt another 18 months after he died.  By that time I had moved to the university side of Vanderbilt and was voted to the Staff Council. My project was to track the amount we shared in our  paychecks to pay for our medical insurance (and parking) each year (the payroll deduction increased about 10% annually) while noting our raises each year (about 5%). While I appreciated the benefits, I wanted people to realize that we were slipping backwards all the time. I quit the Council when I was told to stop; that the administration did not want that kind of information shared with the staff who could not figure it out themselves.  Meanwhile,  Graham, who I had met online in a chat room about 8 years before, asked me to marry him and have my youngest and me join him. He was teaching at a state university in West Virginia, so had a health insurance plan through the state.  He was able to add my son as a dependent pretty quickly but I paid COBRA until we got married.

copayThe new plan was challenging. It was a more standard system with copays and deductibles that had to be met and  with a cap on lifetime use.  Having been exposed to the world of cancer I knew sometimes patients ran into the lifetime limit and care ended, with death soon after. It was horrific to watch knowing a maintenance dose could keep a person alive longer with a decent quality of life.  I started allergy treatments again as my sinuses and lungs were getting horribly affected with the pollution in the Ohio River Valley.  We had no dental care coverage, minimal eye health coverage, and limited options for specialists because West Virginia is one of those places in the nation that just does not have all the choices other places do.

And then the young one left for college. We had to take out an insurance policy of about $1000 a year on top of all his tuition and fees and room and board for him to access the medical care on campus. Then Graham retired and we made our move to Oregon. Graham had enrolled in Medicare and the first problem we had was there were no primary care doctors in our town who were taking new Medicare patients. I paid $500 a month for a COBRA plan from the State of West Virginia when the Supreme Court ruling on the Affordable Care Act allowed implementation. I was pleased because the time limit for COBRA was going to run out before I became old enough for Medicare.

ohpWorking with someone trained in all the offerings, I selected a plan that was good and did not cost “much” It was $550 a month just for me. Since our rate was based on the prior year’s income and we had now retired, we resubmitted about 4 months later with our current income. We wanted to find something in the $350 a month range but instead they enrolled me in the Oregon Health Plan, the expanded Medicaid offering.

I was concerned that I would not get adequate care but was extremely surprised and pleased for the most part. The one issue where the specialist decided not to order an MRI when I injured my arthritic knee (“You have arthritis” he said. “I know,” I answered, ” but it feels different and I can’t walk right.”) and told me to go home. Otherwise, the clinic was friendly, competent and ON TIME.

Last September it was time to re-enroll and our joint income was $200 a month too high to qualify for the same plan, so I had to go back out to the Marketplace and found something for $530.  And OHP dropped me in September but I could not pick up the new plan until January 1. I went three months without my breathing meds ($1000 out of pocket per month) and that set me back to a 20% lung function rating. It will take me about three months to climb back to something better. I have copays and a deductible of $2500. I’m partway there….got that MRI for the knee and that cost me over $700 out of picket because I am working down my deductible.

So, the point here was not to bitch and moan. The point is to show that health insurance has ALWAYS been confusing and ALWAYS has been inaccessible to a large group of the American public.  Prices ALWAYS go up. Benefits ALWAYS go down.

But I sure enjoyed the Medicaid plan. I would be willing to pay an affordable monthly fee for a plan that allowed me to get care without any copays or deductibles or lifetime limits.  THAT was a joy.cost-of-healthcare