Identify what is most important )0( Eliminate everything else
The idea that some lives matter less is the root of all that is wrong with the world. Dr. Paul Farmer
The suffering of others is not alleviated when no one knows about it.
There is no one right way to live. Daniel Quinn Ishmael
The only thing that you need to start an asylum is an empty room and the right sort of people.
We are what we pretend to be, so we must be careful about what we pretend to be. Kurt Vonnegut

Monday, February 29, 2016


I received a call from the cardiac rehab department at the hospital.  They were reminding me to be there and advised me on what to wear and to allow plenty of time for the evaluation.

Then, she told me that they had checked my insurance coverage and my co-pay would be $35.00/US.
Each time.
Three times each week.
Twelve weeks.  Minimum.

When I checked with my insurance company last week I was told that rehab was completely covered.  I guess not.

The conservative total for this will be more than $1200.00.  It depends on how quickly my heart heals.  I told her that I could not afford any of that and was feeling just plain crappy when we finished.

I called the health club at which I can have a free, although limited, membership.  That membership is provided by my insurance company.  They are happy to have me, even so recently after a major heart event.  So, my plan is to go there and sign up after my first and, likely, last rehab appointment.

So, anyway, I was feeling better because they help heart patients there all the time and I will have the information from my rehab evaluation session and I was offered a free session with a personal trainer to help me set up an exercise plan.  I was feeling even better.

Then I received another call from the hospital cardiac rehab department, and the woman who called told me it was pointless for me to use the evaluation appointment if I was not planning on continuing for the whole term.  I explained that it was not that I wanted to avoid those, but that I could not afford to continue.  She was not very nice and I had the feeling that I would become a lost cash-flow patient.  I began to feel terrible.

She went on and on and I kept apologizing for not having enough money and finally she said that I would need at least four sessions and that I would be inadequately prepared for a decent recovery.  By this time I was crying and trying to not let her hear me.  I told her that I would take good notes during those sessions and take whatever brochures they might have.  Still scolding me (at least it felt like that to me) she agreed to let me come to the first one, although she stressed that what I could afford would be inadequate.  I promised her I would do my best and she told me that rehab was not supposed to cause stress and that I needed to take a deep breath.  I am feeling a little weepy just writing this.

So, anyway, I will go this week and take the sessions I can afford and figure out how to get the rest of the money so that I can take the entire course, as I do not want to die right now.  The survival rate for heart patients who take full advantage of cardiac rehabilitation is over five years.  Those who do not take the therapy usually die within three years.

I have a small investment that I was holding dear for the years to come, especially if our Social Security system fails, but I have two choices.  I can sell that investment, pay for the rehab and hopefully get a few more years.  Or, I can not sell it and die without being able to eventually use it.

There really is only one choice.  And, I guess what bothers me the most about this whole freaking mess is that it is simply another aspect of the Haves, those who have enough disposable funds to afford better insurance as well as the added costs of rehab or anything else health-wise they need, and those who do not have. 

I used to be one of Haves.  I had to go through hell to be one of those folk, but I was one until I could no longer be in that other life, where I would have died and, interestingly enough, avoided this heart problem.  I am not complaining.  Really.  I have the means to sacrifice and get the health care I need.  I am not happy about it, but as I said, I would so much like to live more than a couple of years longer.

I was still stressing about this whilst watching my grandsons so that their parents could celebrate their anniversary.  It is only their second because they married on leap year day, today, February 29th.  And, I was thinking, what do people without insurance do, and I already know the answer.  I lived it when I was homeless and going through the divorce and it is a disgusting factor of life for most of the people I have worked with during the past decade.  More.

Many of my clients, and others with whom I have worked, have never had any kind of health insurance.  They, their spouses, their children and their parents share a legacy of need that includes so many of the things that we take for granted.  We may be socially conscious, be volunteers, make donations of money or time to worthy organizations or we may not.  And, you know, it really does not matter beyond the moment of giving or helping because those problems are not going anywhere; they are simply and dishearteningly waiting until that moment of help passes.  There are not any long term solutions to anything connected with poverty.

Except that I believe there are solutions.

Education for everyone, even those students and families that are challenging.

Job training for those who slip through the cracks of our educational system and can turn their lives around at any age.

No one has to throw money at anything poverty related.  People just need the extra help they need.  Not one single person is beyond help and learning, no matter what crappy choices they have made in their lives.

It is interesting that my daughter and I had a similar conversation when I was in the hospital.  It centered on how difficult of a time I was having choosing a candidate for whom I could vote this fall.  She is a staunch Republican (where did I go and I am a tree hugging, Berk wearing, granola eating pacifist and as Independent as it is possible to be and still be able to live among other people.  Really.

It delved into health care and other social constructs and at one point she said that she does not enjoy talking about politics but she loves talking with me.  Sweet girl.

And, there we are.  I am no long a Have, but because of some resources and an amazing family I am managing to avoid be a Have-Not.  I am not going to let the loss of that cushion bother me, because I believe that I will always have what I need when I need it, and I guess that is why I have that small investment and why I have it right now.

I am hoping that that I will not feel unwarranted sensitivity and and a poor-me feeling when I meet that woman at the cardiac rehab place.  I will pull up my BGP before I get off the elevator at the hospital, although I will have to hope that it does not contain a camera. 

There are times when it is difficult to remember how blessed I am, and those time slide right in so easily that I barely notice until my panic subsides.  I cannot let fear or loss or need or anything that helps me feel deprived, because I am not.  I have a life worth fighting for and worth sacrificing for over and over again.  I deserve this now new life, no matter how long it lasts.

And, I am absolutely not going to waste a moment on anything but happiness and safety and love and family and all that I can cram into every single moment.

Friday, February 26, 2016

don't even go there

post weirdness

The whole hospital and surgery thing is still surreal.  I had an appointment with my internist yesterday.  I was a little breathless from getting ready and rushing to the clinic and she did another EKG, which was fine, but she cautioned me that if the same thing does not go away in a minute, or if I experience any pressure or pain that I have to go to the emergency room again.

Fine.  I would rather be thought foolish, heck you can even call me a freaking idiot, than to die from this after everything that has happened in this wee charmed life of mine.  I am sure that wonky things happen to everyone, but I wonder how many of us recognize the times when we nearly did not survive some thing.  Me, well, since I left that other life, I kind of dwell on those past events.  Not intentionally, but if one pops into my mind, it stays there a while and it helps me to be grateful for being here and having this new now life.

It has a second component and that is I examine what happened and try to find alternatives for what I did or said or thought that might have changed the situation or circumstance.  Most of the time I am clear in my mind that I could not have done anything to change the result or defuse the situation.  I guess that is the proof that I was helpless to change anything.

Yet, there are other times when I have such yearning for better intuition or foresight or something that I could have used to alert myself to the coming storm.  That complete lack of knowledge was how it was in the early years.  I got along just fine as long as I followed the rules.  As that first ten years went on I had a kind of happiness that I was making him happy.  It is only in retrospect that I realize I was simply finding ways to survive.  How stupid that young wife was...I can hardly accept that she was, still is, me.  It took too many years and too many close calls for me to leave.  Amen.

This heart thing is different.  Despite months of self-diagnosis, I still paid attention to the pain and went to the emergency room.  I did not think of it as a close call, despite the speed at which everything happened, until my internist appointment. 

I asked two questions that I did not want to wait to ask my cardiologist (I have a cardiologist??????) week after next.  The first was about how the artery in my wrist heals after the stent surgery, which is just fine.  It is a slightly more extreme version of drawing blood.  That has to be the understatement of the year.

The other question was about the general health of my heart, especially concerning the plaque deposits. 

The stents were place in the branches of my left coronary/main artery.  That artery was completely clear of disease.  The central branch was the one 90% closed, with all of its branches clear.  The other two stents were placed in the left branch off of the main artery, in two of its branches, which were 90 & 70% blocked.  The rest of my heart is disease free.  I had fully expected to hear that I had damaged my heart in other ways, but that is not so.  Nice.

After the discussion and demonstration of the arteries, she leaned towards me and told me that I narrowly escaped a major heart attack, by a day or so.  How anyone can know that I cannot understand, but perhaps these doctors know from experience or something.

I am one super-lucky girl.  Anyway, I begin my cardiac assessment next week and after a treadmill stress test we will have enough information to begin rehabilitation therapy.   Despite my aversion to exercise, just like the blood thinning medications, it is going to be a permanent part of my life.  Like, until I die, which after all this, I hope is a long time in the future.

I felt strong enough to do some spring cleaning today, but stopped twice when I felt a little breathy.  And, yes, if I am going to clean, it is going to be a nice, deep clean so that straightening and dusting will seem like little pleasures.  I, personally, find that hard to believe, but you never know.

One more thing.  I thought I was saving money by buying shelf covering at the dollar store.  I was wrong.  One roll covers only the front of one my cabinet shelves, in a very small cabinet in this very small and old kitchen.  Man.

Off to have a salad lunch, with one of the big beefsteak tomatoes and some avocado I got on the way home yesterday.  Healthy hearts unite.

Allrighty, one more thing.

Do not take your health symptoms and/or concerns lightly.  Despite the commonly-thought reluctance of the male species to avoid going to the doctor, it turns out that women are even more reluctant, often waiting until something has become more serious.

I have been having those pains, in one manifestation or another for a  very long time.  Even though I am painfully honest now, I have not yet shared that I had these same pains twice before, attributing them to having pneumonia.  What an idiot I am.  I mentioned them to my doctor, but did nothing to stress how painful it really was.

Do not do that.

Heart disease symptoms are often (not always) different from what men have.  Mine were even different from what the traditional symptoms are for women with heart issues.

That is why I was so certain of my self-diagnosis and my doctor was not overly concerned (even though we talked about heart health) since I had successfully passed a nuclear stress a scant six months ago, there had to have been some indication of disease even then. 

During my appointment yesterday she told me she was sorry.  I told her she did nothing wrong, nor did she miss anything.  And, the truth is exactly that.  She gave me excellent care.  Assigning blame is a place that we are not going.  I am not even blaming myself for being timid about my symptoms and the entirety of my life of no concern about how my eating and lack of exercise could be contributing to my health.  Same thing for the stress I lived under for more than four decades.  Maybe longer, but I am being conservative.

My life is a No-Blame-Zone.

Wednesday, February 24, 2016

she was eaten by wolves. and, then, they ate her dogs.

That is the answer to the question, "How did your mother die?"

More about that later.  So, anyways, there I was, salad finished, still hungry because I have cut way-way-waaaaaaay back on how much I eat since getting that crappy cold six weeks ago.  During the first two weeks I had little appetite.  Full of mucus leaking out of everywhere.  Stuffiness, congestion and a cough that made my lungs ache, or at least the chest and back muscles that support the lungs, or at least outside the rib cage.

That cough hung on and the pain got worse, got better and got worse.  It began just over my left lung and/or in my left arm pit.  Spread as the days went on.  Shoulder, chest and back, under left breast, left neck/jaw/face.  I had a test follow-up a month ago and my doctor and I talked about that pain.  She said the first thing she thinks of is heart problems, but I had a clear and pretty darn healthy stress test before last year's biopsy.  And, I kept insisting that it had to be associated with my lung, the coughing, congesting, mucus plugs, asthma, the whole big, gross thing.

I was wrong.

Thursday last I spent the day at my volunteer job at the food pantry/thrift shop.  It was my first day back since I had come down with that cold.  I hauled huge black trash bags full of donation clothing, 25/35/40 pound boxes of stuff.  Lifted, moved, shoved and pulled.  Just everything that we do there.

I went home and had my salad for early dinner because I was hungry and then sat down to read and maybe watch television if I could stay awake that long.  I must have drifted off around six-thirty and was woken by that pain that I have been having for six weeks.  Only, worse.  Maybe the worse pain I have had since giving birth, which was an emergency cesarean begun before the anesthesia took effect.  And, yes, I do remember that pain for the bit before I went down.

This was worse.  Still, I tried to pace it off until I knew that someone had to give me some pain medication, and fast.  So, I tore off my night jammies, pulled on a pair of slacks and a top and grabbed my purse.  I could not lift it, so I took my wallet (insurance information inside), keys and drove myself to the emergency room.   Not to my hospital, but to one that was closer.

I am not sure about the next half hour, sort of generally, but not many details.  The pain eventually went away.  Mostly.  And, I was asked to stay overnight.  My query about going home and coming back the next morning were explained away so that I did stay. 

I was worried about the costs and how much it would cost to go home the next day, feeling very foolish, after a day of expensive and pointless testing.

I had all the tests you can imagine and everyone kept saying how great my circulation was and how great all the ultrasound and stress test images looked and the hard copy was great and everything was great.

I went back to my room.  My daughter and I chatted about what a head-rush the whole thing was and lots of other stuff.  Somehow my wish to move out to the middle of no-where out west came up and I told her that I am still drawn there, and that it might be that my chance to actually move there has passed without me realizing it.  It would have been nice to live in that house I found, old but nice, the barns and outbuildings fairly new and in super shape.  I could grow my food, raise cattle, chickens and sheep, maybe goats and have lots of dogs, for the simple love of dogs, but also for protection from the wolves and coyotes.

If I had, said my daughter, in the years to come, if someone asked how her mother had died, she would have told them that the wolves ate me and then ate my dogs.  We were still laughing when the hospitalist came in and asked how I was.  I replied that I was just waiting to be discharged.  Then his phone rang and we joked about how you should never get between a doctor and his cell phone.  More merriment.

I was wrong, again.  He came back and told me that my stress tests looked a bit off and that I was going to meet a cardiologist and have a catheterization that afternoon, or the next morning. 

Frankly, all I could think of was how grateful I was that I had not had anything to eat since early evening the day before.  Anyway, my daughter left to fetch the boys from school, give them snacks and come back to visit.  Half an hour later I had the surgery.  Three stents, one in a major coronary artery that was 90% blocked, with the other two close behind.

I am home, fine and feeling that it my daughter had not been there through the whole thing, that the surreality of it all would make it even more unbelievable.

So, now I have a cardiologist.  My heart has never been any kind of health concern for me.  The rest of my body needs attention, but not my heart.  I think the weirdest part is that, having done lots of consulting with Dr. Google (Mayo Clinic, NIH) my diet is fine except for juicy red meat.  That is being replaced by more fish, more poultry and ground turkey.

I have an appointment with my internist, one on Tuesday with the cardiac rehabilitation department at not-my hospital, followed by a follow-up with that cardiologist.

Anyway, I feel fine.  Without pain for the first time in a long time.  No so crazy about being unable to avoid regular exercise.  Nope.  Not at all.  I will not protest or challenge what needs to be done, and it is my hope that it will eventually be less horrible, but I am not liking the prospect very much.

Other than that, everything is cool and groovy, I no longer feel foolish, and that is my story and I am stickin' to it.