Showing posts with label ACA. Show all posts
Showing posts with label ACA. Show all posts

Sunday, January 18, 2015

Dear Crisis Intervention of Houston (Carbon Copy to the White House)

Source: JEZEBEL



Crisis Intervention of Houston is proud to be part of a new effort to help save lives through a partnership with the National Suicide Prevention Line Network (NSPL) and the White House.
In January 2009, the Obama Administration initiated a process for the public to voice concerns directly to the White House via email. This resulted in an outpouring of emails from thousands of individuals whose concerns ranged from financial and food assistance, to medical insurance. Some of the individuals who contacted the White House expressed thoughts or threats of suicide. 
In response to the influx of calls, the White House asked NSPL to provide follow-up calls to individuals identified as potentially suicidal. As the Region 6 Center for the National Suicide Prevention Line, Crisis Intervention of Houston is providing follow- up telephone calls, emails or mail to potentially suicidal individuals identified to be living in Houston or the surrounding area. 
Crisis Intervention of Houston is assisting in this effort by contacting these individuals and conducting a suicide risk assessment which requires some detective work and lots of patience. CIH's work is part of a progress report made by NSPL to the White House every week. 
We are proud to partner with NSPL and the White House as we continue to reach out to people in crisis and provide the kind of support that saves lives.

This may be the most humiliating post I've ever had to write.  But I do have to write it.  It is one of those truth-telling days.  The sun is out.  I conquered my phone phobia and called my Mom.  (Yes, I know, it is more of a Mom-Calling Phobia than an actual fear of the technology.)

I do need to say, in defense of any jerkiness in writing, or thought, that my left leg, hip, and lower back, are all conniving against the composition of this post.  There is screaming -- rhythmic, short bursts, nothing arduously continual -- involved, as the Spaz Attacks laugh in the face of 40 mg of Baclofen, 8 mg of Tizanidine, and a Kroger Diet Ginger Ale.

I am a true fan of President Obama, and of many of his policies.  We could do a rundown, but if you're a Dear and Dedicated Reader of this obscure and odd blog, that would be the height of boredom.

Yes, I am trying to avoid what needs saying.

I write the President, and with excessive frequency.  Possibly with excessive openness, perhaps with insufficient deference.  Weirdo that I am, I consider him a friend, especially in the middle of the night when the pain is winning and all of Marlinspike Hall snores in blissful slumber, from the few country mice in our myriad cellars and crags whistling midst dreams of artisinal cheddar wheels, to the Holy Abbot Truffatore, hiding from the heavy duties of his office at the Cistercian monastery, our closest neighbor, snoring with blessed abandon.  If I listen hard enough, sometimes even the muffled snuffling of the Crack Whore napping alongside the whispering waters of the moat reach my hyper-vigilant ears.

What better time to write the President of the United States?

Maybe it was the letter where I chastised the university system that studiously underemploys its many "adjunct," "visiting," and "assistant/associate" professors, denying them not just the oft-discussed tenure but the rarely referred to basic benefits of employment -- a living wage, access to health care, that kind of piddly stuff.

Yes, I bet it was THAT letter that did it, that put me on The List.  I probably said something like: I have deferred my plans for suicide because my brother Lumpy, the Professor, was diagnosed with an evil cancer, already metastasized, the bastard, dastardly enemy!  He had not had enough funds to purchase insurance prior to President Obama and Friends' pushing through the Affordable Care Act and setting up the MarketPlace.  So, by the time he had affordable health care... no thanks to the university for whom he'd labored like a slave for over 25 years... his first doctor's visit came with the ominous pronouncements of "tumors, masses, MRIs, referrals to oncologists." Just months before, he'd made his first ever visit to an ER, only to be treated as a drug-seeker, and told he probably had a rotator cuff injury.  Right.  Make that Metastatic Renal Cell Carcinoma.

So, it was probably that letter that set off the "suicide" risk alarm button in the White House Reading Room, where every letter to the President is closely perused.

Though it might have been any of the letters that tried to explain the frustrations of a "rare" or "orphaned" disease like CRPS, and the idiocy those of us with it are forced to confront in an often futile effort to get help.  I might have used the old chesnut of CRPS being known as "The Suicide Disease."

In any event, the dread telephone rang this morning, after the second night of Screaming Ninnies and ineffective 100 mcg Fentanyl patches, Percocets, Baclofen, and ibuprofen.  The ultimate proof of failure, and pain's triumph?  It bust down the gates of music -- It ran through Ben Harper, The Decembrists, Bonnie Raitt, Eric Clapton, The Band, Townes Van Zandt, Frank Sinatra, various timeless chorales, even knocking Nina Simone off her intimate stage.  Even the spunky Brett Dennen had his red locks blowing in the wake of the pain's wind. Damien Rice was left standing, but barely -- more of a stagger than a stalwart stance.

So I answered a call from a caller I did not recognize.

It was the Crisis Intervention Of Houston (Inc.) calling "on behalf of the White House."

No coffee in my system, but three cats attached to head, right hip, and square upon my chest, I thought, "Well, of course.  Who else would be calling this fine Sunday morning but some suicide prevention hotline on behalf of my friends in the Barack Obama Administration?"

The very nice person on the other end of the connection wanted to make sure I "had access to all the resources" I need.  Beyond a loaded gun, I assured her resources were to be had aplenty here in Tête de Hergé.

No, I managed to set aside morbid humor and reality just long enough to be completely mortified that my finely tuned letters to the President had set in motion, not the rectification of health care and employment injustices impacting human life, itself, but, rather, a concern that I really meant to perform DIY amputations after consuming scads of methadone washed down with the best of a single malt scotch.

So, a sincere statement of thanks to that wonderful woman who made that cold call, and appreciation to the Obama Letter Reader who put me on the Suicide Watch List.

Suicide is part of the daily routine when you live with this much unrelieved pain and disability for this long, and the only assurance doctors can supply is that the future will be the same, or worse. When you don't sleep nearly enough, especially in consecutive minutes.  When "hope" is a construct, and you spend way too much time comforting those you'd hoped might comfort you.  When your financial resources are destroyed, and your career made a laughing stock of a memory.  When you cannot even hold someone else's hand because it feels like an attack with Sand Paper Set Ablaze.  When you cannot talk about any of these things due to the fatigue of those few still around, trying to help.

And when the person upon whom you have dumped the most, with whom you have shared every detail of the journey turns out to be so damned ill, and so ill-treated?  To someone as weak as I am, lacking the stern moral fiber of my ancestors, suicide seems quite the viable option, and so is considered, daily.

But thank you, Crisis Intervention of Houston, and White House staffers, for caring enough to put me on The List.

Imagine the impact if you bypassed those such as me and called some of the suicidal veterans returned from multiple deployments?  Last I checked, 22 veterans a day kill themselves.  They don't endlessly whine, they don't "blog" it, but maybe they write their Commander-in-Chief now and then.

Like I said, this is the most humiliating post ever, and yet, in the intent of all parties is a desire to "do good," and to stop, or slow, the bad.

Dear President Obama...





© 2015 L. Ryan

Thursday, April 24, 2014

A Letter From My Buddy Barack Obama

I love it, more Secret Service Envy headed my way!  Having been the only instructor at Major Gothic Wonder Land University to hold a required class on the day Ronald Reagan came to jabber at the undergraduates, and wave at the picketing grad students, I am a favorite of the Secret Service.  What they can't figure out is the "no-make ups allowed" major exam question that equally (always *equally*) excited my students -- made up of 14 upperclass undergrads and 1 relieved Divinity School doctoral student:
Explain, dissect, conjugate, and defend the following assertion:Michael Reagan, son of United States of America President Ronald Reagan will one day serve on the board of The John Douglas French Alzheimer's Foundation.

Of course, this pretty standard "no-make ups allowed" major exam question was in French, as this was a course designed to dunk -- by which I mean, of course, immerse students into French Lit.  As you can tell from the question, we had just finished reading Samuel Beckett's Waiting for Godot.

Oops.  Train of thought problems, yet again.  I was telling you about the letter I just personally retrieved from my private email account -- known only to my best of best Facebook Friends. [Loud guffaw! I have a fake Facebook account and about, oh, two Friends, all the rest being right-wing relatives.  My two Friends are right-wingers, as well, but tolerant.   Very tolerant.]

So, yeah, it was from Barack.  My buddy Barack.

[Look, let me settle this, as I just was barraged, nay, blitzkrieged by two Super Secret Facebook Friends who are actual full-blood relatives and consider themselves, and I quote:  "progressive as hell, girl!" Fine, let them assert their leftist tendencies.  Yes, their leftist tendencies surpass even my own, to the extent that I doubt either of them have ever voted in their entire political adult lives.  Not even for McGovern.  Okay... I'm telling lies now.  Let's just say that they may temper their support for President Obama due to expectations of a shift to the left by a rather large amount.  Not this profderien, no ma'am! I adore, respect, love, admire, and imitate this intelligent sign of life -- and his awesome family -- every chance I get.  Well, okay, so there are a few things, policy-wise, that could use a slight Marxist tweak, but, most days, I'm fine with that.]

That's right. The President, himself, writing to The Moi, care of, admittedly, the Haddock Corporation (now completely divested from Halliburton *).

 * Can you freaking believe that "Halliburton" pops up as a correction in SPELL CHECK?! How screwed up is that?  I mean does "amnety internatenal" show up in spell check? No, it does not, thankyouverymuch!  Jesus.

Cough.  Yes, my friend Barack wrote to thank me -- just me -- for my round-the-clock, high tech multi-year campaign on behalf of the watered-down Affordable Care Act.  I keep referring him to my other dearest pal, Bernie Sanders, but haven't heard yet how that's going (so much to talk about!).

In the past, as many a Beloved Reader of this blog recalls, I have shared a few of my personally keyboarded letters to our President -- never violating protocol, naturally, but always seeking advice from the now deceased Tante Louise on how best to post presidential correspondence
Well, okay.  Tante Louise and I may have flubbed a few posts in which my buddy Barack figured, but we toed the, er, red line in the, er, sand when it came to my personal, and by personal I mean one-on-one, tête-à-tête sorts of intimate, soul searching, letters.  The whole Flaubert and Bob Herbert catastrophe.  The admittedly odd basketball post.

Even when you limit a search of this blog to "Obama, ACA," there are just a half-dozen or so weird ones...  I mean, omit blog war waged on Walmart, and the regrettable incident in which I claimed not to be able to support "Obamacare" until Socialism was in place.  I was on drugs.  You can tell, I bet.  I mean, look -- clearly, I say often enough that Obamacare -- the ACA, the PCIP, whatever you like to call it -- saved my life.

Probably, that's all my vast reading public needs to know:  President Barack Obama saved my life.
And then pulls off this comedic email in which he pretends I had something to do with this brave legislative and moral effort [ ::waving:: at teddy!].

That is a true friend, indeed.

Oh hell, there is a man in a terribly plain blue suit that has been tailored, clearly, to hold a spare machine gun and drone in the small of his large back... peeking in the badly leaded hand-poured window panes that stud the upper chamber of the Computer Turret.  I have repeatedly and repeatedly asked Barack, even "cc"-ing Michelle, to have the damned Secret Service "STAND DOWN," already!

Jesus.


Lincoln's Presidential Seal



[Hi there, prof-de-rien!  How're they hanging?]

I had to take a moment to say thank you.

Lisa, you made history.

A long line of organizers fought for nearly 100 years to make health care reform a reality, and now we're seeing the results. Millions of Americans have health insurance today, thanks to reform -- some for the first time in their lives.

The work you did is how real, lasting change gets made, and I hope it will be remembered for years to come.

I'm so happy your name will be there, alongside mine, as part of OFA's permanent record of the people who made health care reform happen.

If you know anyone else who deserves to be recognized, tell them to add their name here:

http://my.barackobama.com/You-Made-History

Anyone who was part of this decades-long fight will tell you it was never easy, but it was always the right thing to do. Teddy Roosevelt knew it. Harry Truman knew it. Teddy Kennedy sure knew it.

No matter how hard it got, the results we're seeing today make it all worthwhile. Millions of Americans now have coverage, and even more have better health care, thanks to the work you did.

Take a moment to let that sink in.

It's proof that when people come together and fight for what they believe in, real, lasting change is possible.

I can't thank you enough,

Barack Obama






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Wednesday, April 2, 2014

Go-To-Guy Meets Obamacare

CLPS:
Crumpsall Lane Primary School



CRPS:
NOT a primary school in Manchester, Great Britain

Some people think I'm mad for retaining the services of a "concierge" physician when I've successfully run the marathon of applying for coverage through the HealthCare.gov Marketplace, set up by that wonderful bit of legislation known as the Affordable Care Act.

Okay, "Obamacare." Jeez.  A girl tries to deflate the negative connotations of a term by providing and modeling alternative linguistic monikers and is shouted down by her imaginary millions of Dear Readers.

Yes, I've adequate and affordable coverage now, and desperately needed it.  But nothing has changed, really.  Even when I had wonderful but not so affordable coverage under the ACA's early version of Obamacare -- the PCIP (Pre-Existing Conditions Insurance Program) -- that began back in 2010 and saved my miserable self, I was considered mad for retaining the services of my Go-To-Guy and his flat fee service, then under the aegis of MDVIP.  He's no longer with them, he and his partner.  They're Wild Medicos.  They've gone rogue.  They're MDVIP without the corporation around their neck.

Go-To-Guy saw me through several valleys of death, always opining, in his crisp dark suits, understated cologne, funky eyewear, and with all of the surety of a hardheaded grandmother: "This, too, shall pass." When I had no insurance, he kept me on, and kept me OUT of the hospital. Why was I uninsured, being a bona fide State Employee 'n all?  Because my Bizarro World version of BCBS decided it was fair to charge me $1513 a month as a premium, with a deductible over $5,000.  So while it wasn't a game, it might have been a sporting challenge for myself and Go-To-Guy, as he kept dozens of balls in the air, and never let one fall to the ground, not even once. I became dirt poor, got sicker, but did not die, mostly out of a desire to see my staid and superb doctor kick major butt. Undoubtedly a conservative sort, he hooted and hollered and did backflips when Obamacare was passed, because then I could finally get the surgeries I needed, and the medications that he preferred, instead of the ones that Walmart sold for $4.

It was fun introducing him to the real world.  "Really?  You've got to be kidding!" became the standard iterative upon which all of our problem-solving conversations were built.  I doubt he's ever been in a Walmart.

The real Go-To-Guy is a compassionate, insightful, incredibly well-informed physician who decided that he wanted to return to the art of medicine as well as perfecting his scientific approaches to care. He was tired of dealing with insurance companies and rushing through patient visits -- though, having been with him a good decade before he changed his practice model, I can attest to never once having felt that he was timing the visit or needed to be anywhere but where he was. That's not to say he hasn't had his moments of rapidly rising color from chin to brow, complete with beads of sweat, and a cramping hand grip -- moments when I'd touched some nerve or other.

Go-To-Guy believes in the best of people.  He's shocked by any anecdote that relays an example of less than outstanding human behavior.  He's cute that way and I figure that attribute to be an excellent counterweight to my inbred pessimism.

And yes, there's that business of him saving my life a few times, and there's that aspect of acute intuition bolstered by being up-to-date and actually listening to this whiny, bitchy patient with the weird cluster of diseases.  Truth be told, however, the next time he is going over labs or a radiology report, muttering to himself, and I hear... "That doesn't make any sense... but this is Retired Educator, so who knows?" -- I'm going to bop him on his pate.  Well, as my reach is shortening and my strength waning, I probably could only whack one of his bony knees.

But... with the improvements being made in the field of assistive devices, add a flowery cane or a rubber-tipped grabber, and I could infict serious damage almost anywhere on his lanky body.

Right.
So.

I see Go-To-Guy this week for the first time since January.  We maintain an email correspondence, mostly consisting of Q-and-A sessions and my need to vent.  This meeting will be our first when, technically, I have another physician serving as "primary care provider."  And so, I imagine we will still do a soft shoe rendition of quizzing and catch-up, medication reviews, but now he won't be able to order labs or imaging, or write for meds.

What shall I call my new Primary Care Provider, a young, inexperienced, very pregnant, well-intentioned and woefully-unprepared physician in her second year of practice?  Go-To-Guy and I had gleefully thought to outsmart my new ACA Market Place HMO by slipping the list of available providers to his partner's wife, who works as a hospitalist for the same HMO.  We giggled and called her our "mole." The mole eliminated my new Primary Care Provider straightaway, first thing, with nary a hint of hesitation.  Next to my new Primary Care Provider's name, she wrote, in caps, "NO." Then Our Mole underlined her capped "NO."

NO.  Okay. I bolded it and turned it red.

Mole-guided, I picked the guy with sterling credentials, 15 years experience, row upon row of accolades, and the highest approval of the hospitalists with whom he worked.  I made the appointment and the acid levels in my stomach decreased.

And so, of course, at my first "Meet and Greet" appointment with this fine doctor we chose, talented physician dude announced that, unfortunately, his patient load was already too large, and so, like a snake, he transferred me to the medico who had been branded with the capitalized, underlined negatory.  I must have looked like a large-mouthed bass hungry for oxygen as my lips flapped in the overheated exam room.  He did slip in, the sly devil, that she was scheduled to go on maternity leave in May, and that he would probably pick up my care during that time.

Why insist on choosing that facility?  Why there?  I dunno, really. It's brand new and everyone is super nice, super efficient, super interested in customer service evaluations.  There are onsite lab, radiology and pharmacy services.  The truth? I had visions of needing to flee, and hoofing it over to the safety of Go-To-Guy's office, one street over, and the adjacent two hospitals, in case I needed urgent care. Perhaps, too, a compulsion to talk politics might come over me and there's no one better than Go-To-Guy's gatekeeper nurse, Justine, for potty-mouthed dissing of right wing extremist asshats.

Having now had my second "Meet and Greet," I think I will call my new PCP "The 17-Minute Uh-Huh."  This commemorates our first encounter, spent ordering most of my medications, during which "uh-huh, uh-huh" was the response to each medication I pronounced aloud.  Well, actually, the "uh-huh, uh-huh" began to arrive mid-drug name after the first three prescriptions.  I was getting peeved, but then a strobing pink light induced seizure activity as she interrupted a response with: "Our 17 minutes are up!"

The 17-Minute Uh-Huh has many redeeming qualities.  She's cautious.  She can explain the parts of the ear in great detail (I am having that benign kind of vertigo that comes on whenever I turn my head to the right!  "So don't turn your head to the right!").  This was at our second meeting, brought on by a high temp, a high white count, the aforementioned benign vertigo, and a messed up thyroid assessment that kept stomping its little computerized feet and claiming I had both Hashimoto's hypothyroid AND Grave's disease.  Since everything else defied logic (she's new), The 17-Minute Uh-Huh glommed onto ear physiology.

But I will have a hard time getting over her blank look upon hearing "CRPS," and the aha-moment when I offered up the acronym "RSD," instead.  The trigger of a vague memory brought on the explicitly memorable: "Oh, yes!  Something Sympathetic Something!"

Go-To-Guy has this annoying habit of pulling out some electronic device and looking up things he does not know, or to verify information.  He's particular. And he loves learning. He has other habits I've noted through the years, like the first time he saw me after I "developed" CRPS.  Actually kneeling on the floor, he was carefully examining my right foot -- at the time, the only visibly afflicted part of my body, and that was only a subtle blue hue and swelling, despite the outrageous pain there and in my left hand and forearm. Well, my left hand had a "claw" formation, but I don't like remembering it, so I'll forget it again now. He asked permission before touching the thing at the end of my leg -- compare that to Jose "The Turd" Ochoa and his reputation for suddenly grabbing at affected limbs; compare that to the countless doctors, nurses, and aides who have poked, grabbed, and stuck needles in that region without warning, much less permission.  There are two nurses and one doctor who learned the lesson well when I kicked them in their respective midsections -- I was semi-conscious and on a respirator at the time, if that absolves me at all of such violence.  It doesn't, of course, but all three were wonderfully forgiving.

See how I run from what needs saying?

At that time, the day Go-To-Guy first saw the purported foot, the orthopedic surgeon responsible for its pitiable condition, was Dr. Eric Ward Carson?  Let's get philosophical and call him the Thick Necked Truth Deflector.  In the beginning, there was a different word, a different descriptive expression, very stylized, ladylike:  Dr. Doo-Doo Head.  He denied, deflected, referred, mumbled, threatened, demeaned... did everything but diagnose and treat the obvious.  It was after weeks of that barrage of crap that I saw dear Go-To-Guy.

Me:  "Dr. Eric Ward Carson says this will go away, it's not a problem, I'm over-reacting, and that there is no such thing as CRPS.  He says that CRPS is a psychological disorder."

[In desperation, I had seen a partner of Dr. Carson's, someone very trustworthy, who had replaced my right hip the year before, and had referred me to Dr. Carson for the left shoulder replacement gone woefully awry.  This partner took one look at my leg and said, "Oh no, you've got RSD..." He then went on to deconstruct the acronym, and introduce its pal, CRPS, writing it all out on the crinkly paper covering the exam table.  I still have the bit of paper.  It was my first clue to what was causing so much pain and... well, you know my tiresome litany.  He urged me to see Dr. Carson as soon as possible and start treatment.  But, as I said above, Dr. Carson's reaction was to deny the evidence before him.]

Go-To-Guy:  "It is very real, it is not in your head, and yes, you have it. I'm so sorry."

Why am I ruminating on this bad stuff today?  The mail.  In one large envelope, I received a copy of the labs and my "current problem list" from The 17-Minute Uh-Huh.  In another large envelope, I received a copy of my records from the neurologist I can no longer see -- the Hawaiian-shirt sporting genius, in shorts and Birkenstocks mid-winter, who made the "official" CRPS diagnosis in 2003, who ranted and raved about the cover-up operation put into play by Saint Joseph's Hospital of Atlanta, Dr. Doo-Doo Head, with the ample and able assistance of Doctors Leslie Kelman and Steven Sween.

This Stylish Neuro-Guy, seeing my confusion (at that point, pure fatigue), had grabbed a big book, what we love to call a tome, dedicated in its entirety to CRPS / RSD, and flipped to the big, bright, colored photographic section... and there I was.  "See!  This could be you!" He even loped out to the waiting room to drag a sleepy Fred into the exam room.  "See!  This could be her!"

No, that's not how it reads in the medical records.  There, I am an "unfortunate woman." There, I am diagnosed clearly with causalgia, not RSD -- or in the modern parlance, with CRPS Type II.  Why does it matter?  Ultimately, it only changes a bad attitude.  Doctors who still resist the diagnosis of "RSD" will sing a different tune if you change the name to "causalgia." And there are those who do the same if you say, "I've CRPS Type 2, not Type 1."  The difference relies on the identification through EMG, or nerve testing, of nerve "lesions" as the cause of the neuropathic pain in the path of that nerve. Stylish Neuro-Guy identified three separate nerve lesions, two in my right leg, and one in my left forearm -- the original sites of injury.

It's not a cause for rejoicing, this shift in designation.  In any event, now I have both Type 1 and Type 2, as the disease spread from left arm to right, and right leg to left.  The facial involvement was God's private joke.  But there were times I might have been able to shut up some Talking Irritant by producing the EMG results.  It never occurred to me to get copies, as the "treatments," or lack thereof, are the same, no matter the type.  Causalgia / Type II is taken more seriously because it has demonstrable proof, and, I guess, because its "outlook" is more dire.

So that's why this is all spinning in my head.

Because here I am again... reinventing the wheel with "Oh, yes!  Something Sympathetic Something!" and referrals to the same orthopedic surgeons who have already tried their damnedest to save my bones, likely infected at the time I "acquired" CRPS.  Oh, to take that moment back.

Here I am, still fighting bill collectors who are calling to grab illegal "balance billing," stuck in a wheelchair and a freaking hospital bed, reliving the diagnosis with each newbie doctor, repeating tests that do not need repeating and that has done nothing but grind, grind, grind in the reality I'd be best served to forget.

My new Primary Care Physician, The 17-Minute Uh-Huh, still has CLPS listed as Number One on my Problem List. I wonder what that stands for?  A quick search turns up:

CLPS Colipase Pancreatic
CLPS Closest Lattice Point Search
CLPS Criminal Law Policy Section (Canada and Australia)
CLPS Calibration Lamp Power Supply
CLPS Common Logic with Power Supplies
CLPS Center for Logic and Philosophy of Science
CLPS Crumpsall Lane Primary School (UK)

I'm going to go with... "Common Logic with Power Supplies." I definitely have huge problems with common logic, and power supplies?  Don't get me started!

So, heck yes, my mocking detractors, I will forego my one Diet Ginger Ale a day, consider halving my coffee intake, eat canned tuna in lieu of fresh tilapia, cut off television service, sell whatever I have left to sell (a food processor, meat grinder, and a snazzy fondue set), to pay for access to Go-To-Guy, my concierge practitioner, who knows to ask permission before touching the thing attached to the purported limb adjacent to my rotting right hip.  He's my back-up, my reassurance.

He's Go-To-Guy.



2013 L. Ryan
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Wednesday, March 12, 2014

Another Shower, More Chicken Soup

I ran into another person.  No, let's rephrase and reconstitute that!  
I came across another situation peopled with idiots, and the situation does not allow for the differentiation of the well-meaning idiot from the uncaring idiot from the trained monkey with flat affect.  
That's right!  It was a lawyer.
And it made me think of this post, written last October 23, and the poem which concludes it. 
You can't tell, but the air here today is rank with that smell peculiar to desperation.  It's in the sweat, it flits from the pores, the lightest of emulsions.

There is not a story behind every poem.  Every poem is not "true." Not all writing is autobiographical.

Because of my "success" in typing through the minefield of the ACA online Federal Marketplace, actually succeeding in finding very good and very affordable health insurance that will maintain my near poverty very well, my name has been given to several media outlets.  Among them, CNN.

The reporter who interviewed me, twice I think, if we don't include today, does not listen.  He wants a certain response, of course, and steers his interviewee in that direction.  You can tell he is not listening because he often begins his "next" question while you have not finished, adequately, the answer to the current one.  And by the tone of voice, and by the fact that he does not seem to retain the information you have given.  But, who cares?  It's his métier, let him be good or bad at it, and let that be his choice.

So I did my part.  Never was there a mention of actually being recorded for televised broadcast -- nothing beyond audio, I presumed, since it never came up.  I assumed that I sucked so much as a subject that it just wasn't even a viable issue.

And besides, life has gone on in the interim.  Damn it.

I had a bad night last night.  You know.  Screaming, which oddly enough assumes more and more dreamlike status, whereas gentler moans will actually wake me from real sleep.  Lots of pain, lots of infection symptoms in the shoulders and hips, and so on and so on, ad nauseum.  You know the Punch Line:  the screaming ninnies of spasticity.  I didn't even bother with meds, just put in the earbuds, sang my heart out between yelps and sometimes must have slept... if those moans really did bring me back to consciousness.

Concern for Fred.  Concern for me and Fred.  Regrets.  Wishing I would die before sun up, so that my room might be redolent with the odor of roses.  That's right, you reprobates, I fully intend to die a sainted death.  I like this new pope and have already put in the paperwork for sanctification.  You laugh now, but one day you won't.

So I finally get the screaming meany ninnies to stop, close my eyes, rest, and the phone rings.  As I am waiting for several important calls -- maybe even El Papa, himself -- I pick up, something I never used to do before the crisis with the Mother-Unit.  Now I am a true adult, ready to speak to anyone, medical bill collector, Mother-Units, veterinarians, friends (ha!), insurance company, or rambling, ambling CNN reporters.

My "Hello" might have been deceptively bright -- the sure way to know if you have awakened some poor soul at the other end of technology.

Anyway, he yadda-yadda-ed and then asked about bringing a crew over for a quick recorded interview.

Now I had given this journalist person full access to this enlightening blog -- such a simple document -- and even suggested a few of my pristine video selections on YouTube (channel "profderien"), not so much because I was whoring myself, but because I figured he needed to understand that between being butchered half to death these last few wonder years, and having CRPS in all limbs, including my frigging face, that I would not be given to appearing on television.

I cry when I see myself.  I can handle the CRPS update videos, done mostly for the CRPSers in my small but dedicated audience, because it is piecemeal, it is abstracted, somehow, and I can include touches of minute humor.  But... take the elevators in my go-to-guy doctor's building.  The doors are mirrored.  So there I am, in my wheelchair, surrounded by normal looking folk, looking... grotesque.  Seen as a whole, I do not recognize myself.  Not just from the CRPS, not just the wheelchair, the legs, the hands, the face, but also the impact of over 15 years on steroids and clothing that was designed for gimps.

You'd have to be an idiot to read this blog and not know that every mention of high-powered italian leather shoes reflects my love of shoes.  I haven't been able to wear shoes for over a decade.

I mean... I thought a reporter would GET IT.  But then, I made an assumption based on narcissism (a decent definition of "hubris," really).  His story is not about me.  It is about "Obamacare," something I desperately want to support, and had been handed a mighty vehicle with which to do my small part.

I love my step-mother with a full and aching heart.  But I would never let her see me.  Not now.  I love TW with a heart more than full, more than aching... and never will he cross the threshold of The Manor's Bronze doors.  I will let Grader Boob (the other Brother-Unit) in... but only because he was wily enough to stop by once already.  And because he's been here, or there, through it all, anyway.  Because I don't think there is much left that can shock him -- more is the pity.

So something led me back to that freaking file of writing that I did earlier this year, and to this poem written kind of for Fred and kind of for the new friends I was making, who were wearing me out with suggestions for cures.

People don't GET IT.

This is the poem I wrote, for people who don't GET IT.  There is no imperative that they should, but there'd be a deep water well full of gratitude if they did.  So, in this unimportant instance, "A Shower and Chicken Soup" is dedicated to John Bonifield and Elizabeth Cohen, with all due respect.



A Shower and Chicken Soup

"Have fun," she called, and waited
for the sound of the key in the lock
to ready herself for a walk.

"Just do it.  Just do it.  Just do it,"
she said, eyeing the clock.
Not exactly scared -- more properly
put -- she was reticent.
"Don't dare mock me,
cats, and don't dare
get underfoot..."

Transfer from bed to chair using
one step with the right leg,
which leg is the right leg?
(they are easily mistook
these dread and crafty limbs,
one for the other, just look
at 'em) add a table grab-'n-push
with the right arm,
find the cane! find the cane!
then pivot, pray, and sit,
stare straight ahead,
it will ease, it will away,
will it away. where is that
leg now, cagey bastard?
It can stray, did it stray?


We said we'd walk together baby come what may
That come the twilight should we lose our way
If as we're walkin a hand should slip free
I'll wait for you
And should I fall behind
Wait for me

Reach to retrieve three towels from the half-bath,
folded earlier today, towels in waiting,
attendants all. Remove the Fentanyl pain patch,
dispose of it carefully, lest you kill a small animal.

(By accident.)

Take off the pink metal-studded hairband,
that wonderful confusing message!
You stall as you recall, you stall as you recall.

Gather the grabber designed for water,
aquamarine with finely molded tips, the three towels,
a clean pair of scrubs and the veterinary formula
of skin cleanser prescribed by the infectious disease specialist --
because you cannot afford the stuff made for people
and, it would appear, there is no difference.
This is labeled: For Horses.

It lacks in fragrance. It's not honeysuckle, trenchant lemon,
clement cucumber, or any of the serene green teas.

Poured in an old spray bottle accorded precisely
scored markings of perfectly proper proportions,
add the fragrance of the week,
something he deplores but you love:
Lavender.
(I picture fields of flickering blues;
I don't like the smell, either.
It smells too much.)

I shower in his bathroom.
The chair won't fit the door.
All these fine parameters, tincture of this,
precious local provender,
And the chair won't fit the door.
Grabbing on to sink and towel holders,
using my peony-decorated cane,
I lean on the tile at the shower-and-bath
combination corner, keening, keening,
so afraid, leaning, keening.

Toss the towels, the grabber, the cane,
the clothes, all, all of it goes, flying and clanging
into the bathtub, as you inhale
and search for sane,
focus on the pretty pretty cane.

Lift in the right leg, drop it,  scream,
and grab for the stabilizing bar
on the opposite side, my guard, above
the soap dish, with my right hand,
half pull, half fall inside,
the abattoir, hips on the shower
chair that stays in there,
that stays in there.
There is a screw poking through
the plastic, you said it did not match
the pre-drilled hole, and I always land on it,
ripping my clothes, scratching my right thigh.

I never tell him because this piercing keeps me focused
-- spastic and sarcastic --
this is what keeps me from screaming more:
the mean cost of a small scrape.

I cannot reach the mat that keeps me
from slipping; it's now on the left,
therefore unreachable.
If what I need is not within
the right's realm,
it cannot be mine.
She sighs, she cries,
she stops, she stops.

She stops,
thinks of the clock
and how there is no time
for this sighing, this crying.

Now for the undressing, the easiest part:
The few moments of liberation,
nothing touching the skin,
and I would sit there naked all day
except that he'd come home
and I'd still be unclean,
my hair a fated mess, and my legs... my legs.
My hated fenestrated legs.

Right arm tosses the dirty clothes
just to the right of the sink,
but not too far, not to block the way
out, not so the door won't open.
I'd be trapped in here,
and that would defeat
almost everything.


Now everyone dreams of a love lasting and true
But you and I know what this world can do
So let's make our steps clear that the other may see
And I'll wait for you
If I should fall behind
Wait for me


Use the grabber to put the clean clothes over the shower rod:
This will take time and patience.
Put one towel on the tub floor
in lieu of the non-skid plastic mat
that is too heavy to lift.

Put the veterinary antibiotic spray poisoned
with lavender on the tub floor
between the feet.
Use the grabber to retrieve
the shampoo and conditioner,
the purple "pouf"
from the shower caddy.
Pick up the pumice stone and loofah
that you knock
off by mistake,
and replace.

Brace yourself and slow your breathing.
Turn on the hot water first; it takes 20 seconds to warm up,
then adjust the cold so that the water becomes lukewarm
to your body, to your chest;
do not trust the readings of your legs or hands,
your face.

Hold the shampoo bottle in your left hand, and be glad that it naturally
tilts downward so your right hand can catch the coconut (for extra body) white
pool, slap it on your head, one more time as fast as you can, and catch the shampoo bottle before it falls on your feet -- your foot,
because that right foot is like a magnet.

Lather, being as attentive to each side of the head as possible,
grab the grab bar, lean forward into the spray, get all the shampoo out.
Apply the conditioner in the same manner.  Start your mental clock.

While it's making your hair luxurious and smooth,
spray your body with the antibiotic cleanser meant for horses.
Don't rub or scrub it in, just let it sit, keep spraying until time to rinse
that lovely head of curly hair, about three minutes
(an extra minute for luck).

Rinse the conditioner from your head, try to stop crying,
because looking down you see red streaks in the froth
of the foam
and feel your skin splitting,
small tears in both shoulders, the thighs,
the right shin, the feet,
and maybe that spot on your butt
from the poked-through screw,
but probably not,
there's actually a callus there now.

Bend and twist and let the water rinse away the spray
then lather the purple pouf with soap
and gently gently wash every place that you can reach
from head and bloody ears to bloody toes.

Gasping now, wanting so to take the memory of a lovely warm shower
coursing down skin so silky, relaxing muscles tight from a day in the sun
playing pick-up tennis at the park courts downtown,
pausing to cool down with wall ball now and then,
cramming the car full of kids to drive to the last surviving
pharmacy with a fountain to get real lemonades, limeades.

Holding my face right up into the spray, hands over my head,
running through my hair, short then,
the idea of standing through a shower
now as foreign as saffron.

Rinsing, she has learned, is crucial, as she's never
terribly dirty, just a mass of dead skin and sweat that her twice
sometimes thrice cleansings per day obliterate, but the lotioned,
medicated cleansers so recommended leave traces, traces,
bits, hints, lint, evidence, of themselves
and her inabilities.

Her stepmom used to comfort her when the flu would hit,
bustling about efficiently, able to do a sickbed mise en place
but lost before the recipe ingredients in her huge kitchen.
equipped with culinary's finest stainless.  She bears bedside
basins and washcloths, clean gown and sheets, and as she talks to you
about the plans for redecorating the breakfast nook, she
untucks the top sheet, helps you off with your gown,
and, keeping you covered and warm,
she washes and rinses clean your face, your arms,
your arm pits, wipes down your legs, but really scrubs your feet.
A matter of fact, she hands, at the last, two wash cloths,
one soapy, one rinsed, to clean between your legs
while she gathers up all the dirties, holds out the basin
to collect those last two cloths, and takes it all away --
but is back in a flash, saying, "That takes care
of the hot spots, you see.  Always wash the hot spots,
and always wash your feet, you will feel so much better.
Now don't you feel better?"

All in her sweet southern lilt that belies
the swift efficiency
of a born nurse,
if not a mother.

She slips the clean gown, your favorite, blue with blue ribbons,
over your head, helping with the confusion of arms, laughing,
and simultaneouly removes the dirty, now damp, top sheet.
She pulls the wing chair she says is for "reading" close and
before you know it, you're ensconced in it, and on the bedside table
is her famous Campbell's Tomato Soup and whole
wheat toast, for dipping.

You can't eat it all, that's fine, and look, the bed's all made,
amplified with extra pillows, the sturdy kind, the kind
that have you sitting up and doing crosswords, or reading
(outside the reading "chair"), and looking out the windows --
(when did she open the drapes?) and looking out
to see the woods.

You notice that she's gone.  You cannot remember if you thanked her.
The house is huge but even in huge houses, you know every sound and
you detect the tiny click of the other wing's separating door
and laugh, hearing the advancing, slowly speeding click-click-click
of the small thing they call a dog, coming to amuse you.
Oliver, half cocker spaniel, half poodle, sweet and small
and not ingenious.

There is nothing for it but to do the feet,
let the tub fill up six or nine inches, try to move
them around a bit, take the pouf by the grabber --
now that is a saying wanting wide adoption:
take the pouf by the grabber, lads --
and gently scrub unless too much skin
slides off and pinkens the six or nine inches.

When the water drains, give the feet a good spritz of Magic
Lavender Lavage and do what you can to make it seem
you'd never been there.  Grab the grabber, lads,
and take up the sodden towel, wipe and spray,
wipe and spray, leave no microbes
alive.  Die, pathogens, die.  Disappear,
O Flakes of Me, down the drain.

And now you fold up, you ball up like tissue paper, lose
form,  lose patience with yourself and this, your accomplishment.
Dizzy, naked, and still clothes to wear and hair to do,
and my, you are aromatic.

It takes two towels and a method:
Dry the hair, gently, and toss the towel in a slap
to the back as many times as you can, then
rest.  Without giving it much thought, pull
up on the steadying bar, and stand.
Put the towel on the seat and sit back on it
as that is how one dries the derrière when
exhausted and the right arm ready
to give out.

Take the second towel, toss it over your legs,
gently, gently, stop, stop, stop.
Grab the grabber, lads! Grab the grabber, boys!
The clean top pulls on, hitches where the skin
is still wet, damp, humid. so be
patient. Be patient.

Grab the grabber, lads!
Grab it, boys!  Unfurl the scrub pants
that always look so huge until you have to put
a foot in, matching right foot to right pant leg,
left foot to left pant leg, yelling, screaming,
rivulets of pink, mostly sera now,
mostly lymph, but every inch aflame.

Scan your area. Is all that can be in place
in place, is there no embarrassment left to shame
you?  Your top is on, your pants around your ankles.
Hang the blessed grabber on the caddy, grab the bar
and stand again, yelling, screaming, those noises cannot
be my bones, mobilize your self, girl, get the waist
of the pants with ye olde grabber, pinch them with your left
hand, finally good for something, and use the right
to pull them up and fashion loops resembling a bow.


We swore we'd travel darlin side by side
We'd help each other stay in stride
But each lovers steps fall so differently
But I'll wait for you
And if I should fall behind
Wait for me

Hug the wall, no other description writes, hug the wall,
the hooks there mere inches from your eyes and every time,
every time, you think my eye my eye my skull my skull
impaled on this hook, and after I've done all this?

Crying, sobbing, more because you are almost done and
because you can, because he's not here to hear you,
you edge to the door, using grabber and cane, both
for crutch, then fall into the chair, waiting there
like an old hated friend, with two cats, big-eyed and
scared by all your noise, and about to be crushed by your
descending butt.  They run, squeaking, happy
that you made it out alive, in time
to feed them.

The cane now more useful held by the bottom end,
using the handle to hook all the towels and clothes,
pulling them to you, then bending, if you can, to grab them
up, pile upon the bed, ready for the washer.
You're almost done, you're almost done,
you're almost done, stop talking and breathe,
stop crying and breathe.

Comb out your wet hair,
and there's a memory of normal,
clean, fresh hair,
a touch of mousse --
shake the can in the right hand,
spray it into the left, scoop it out with the right,
smear it on the parts of the head you
can reach as the muscles seize, don't take
the pills, not yet, you'll hurt more later,
and they really don't help, it's more a crutch
but far less useful than cane and grabber.

Music, music, as loud as can be.
You've got a half-hour,
at least, love, play your music loud, raucous,
scream that and not despair.
Bruce, "If I should fall behind,"
Nina and "Mississippi
Goddam!" and I am suddenly sure
that I am an outraged black
woman, singing my piece, and I enunciate,
with incredibly sober drunken dignity:
"This is a show tune

But the show hasn't been written for it, yet."
Then I hear that earliest of bonny Bonnie
Raitt, so clear it breaks my heart, and I am
young (coveting that head of red hair),
singing with blue's greatest
in my parents' garage.

I put on my armor,
my three rings, my three bracelets,
my four earrings, my kickass hair band,
pink with rivets. Each thing a touchstone,
a meaning that I must wear, touch, and see.
I wish to God I could pluck this unibrow
but I cannot see well enough to do it,
nor control the hand enough to pull out
hair by hair, those straggling hairs.

But enough of what you can't do,
princess, look at what you've done:
you are clean, deloused, and you certainly smell
interesting.  There's a load of wash going,
and if you don't allow yourself to slow, to stop,
there's a chicken with some meat still on its bones
the start of a marvelous stock.
We've carrots, celery,  onion, garlic,
dried and earthy things --
squashes and four kinds of peppers.

I'll wait to see what you'd like for starch, perfectly diced
potatoes or the weight of brown rice or aromatic basmati
or jasmine, maybe beans (I vote potato).There is,
not that we can find, no Italian in you, anywhere,
but you will likely ask for noodles, without encouragement.

I stir in, at the last, my great love, musty lusty
mushrooms, buttons and baby bellas, and when you ask me
if I washed them, amplifying, eyes all squinty, adding "with care?"
I turn away and lie, like always:  "But, of course,"
having wiped each one with a clean cotton cloth napkin,
having pared away the stems you so fear
(scary, scary stems).

You're afraid of strange
things, but I respect your fears,
because I have seen your courage --
still, your terror of my green Amish bentwood rocking
chair amazes me, and the sweat of your upper lip
at mere mention of hot air balloons, and, of course,
being killed by a dirty mushroom.

Should we lose each other in the shadow of the evening trees
I'll wait for you
And should I fall behind
Wait for me

When you come home, I hear the key in the door,
the ever hysterical "Honey, I'm home" done in bad Arnaz.
And I am so glad you never notice that I've showered,
though you usually call from the back, "Do you want me
to put your the wash load in the dryer?  When are we
eating?" And I remember to inquire about potato,
rices or beans, know to pause and wait for "how about pasta?"
I pick rotini instead of egg noodles, cook them separately
so as not to muck up my perfect broth,
and remind you to be better about buying
canned tomato products with added salt,
and spices.

I want my tomatoes unseasoned.

I add my own seasoning, and I love you,
and I will shower, dress, and adorn myself
with clean clothes, aromas,
talismans, prayers, and cries to the sky
as long as I absolutely can, for you.



]with thanks to The Boss]

© 2013 L. Ryan Follow my blog with Bloglovin

Thursday, January 23, 2014

My First Use of Obamacare: Two Thumbs Up

Dear President Obama:

I thought you might like to know how my first use of "Obamacare" coverage, obtained through HealthCare.gov, went, and whether it was, in general, a thumbs up or down situation.

Two thumbs way up, sir!

I saw one of my new doctors on Tuesday. Due to electronic transmission of records, my daunting list of 20 medications preceded my arrival, so figuring out which ones required immediate renewal was easy.  I needed x-rays of my decrepit bones and got them, immediately - while  my prescriptions were filled.

I mentioned to the doctor that my former internist wanted me to have a hospital bed, with a trapeze (I've always wanted to be one of the "flying Wallendas"!).  I try to follow the Rule of Threes when I see a doctor and only mention 3 concerns or needs.  More than that can be overwhelming.  So, though I mentioned the bed and trapeze, I was not sure he even heard me.

Guess what is arriving at my home this afternoon? That's right!  A hospital bed with trapeze. Two days after mentioning the need in passing, almost under my breath, and voilà.

While writing this letter to you, I got a phone call, scheduling my first appointment with a pain management doctor in March.

I was treated courteously and professionally at every turn.  There were no flashing lights over my head announcing "Obamacare recipient, receiving tax credit assistance with her premium, despite enough medical problems to bankrupt the entire nation." None of that!

I filled 5 prescriptions for $75. I paid a $30 co-pay to see the doctor.  There will be a rental fee for the bed/trapeze, but it goes toward my reasonable deductible.

It almost feels like America again.  I don't feel like a "taker," or someone having great fun with "entitlements." I am paying my fair share, and struggle to live within my means.  I am a "permanently and totally disabled" French prof, who gladly would give up hospital bed and wheelchair to stand in a classroom again, sharing, helping, guiding, working.

This was certainly not how I envisioned things turning out.

It's my birthday tomorrow and this is my first "thank you" note: for the gift of "Obamacare" and the ACA, for the gift of people who listen and hear, for the many people who make a tough life tolerable.

Anyway, that's how my first use of my new coverage worked out.

Excellent work, Mr. President, and thank you.




© 2013 L. Ryan

Sunday, October 6, 2013

Dear President Obama: My Experience at the HealthCare.gov Marketplace

Hail to the Chief we have chosen for the nation, 
Hail to the Chief! We salute him, one and all. 
Hail to the Chief, as we pledge cooperation 
In proud fulfillment of a great, noble call. 
Yours is the aim to make this grand country grander, 
This you will do, that's our strong, firm belief. 
Hail to the one we selected as commander, 
Hail to the President! Hail to the Chief! 







Dear President Obama:

Every nerve ending in mine body is frayed, frazzled.

I began the search for coverage via the HealthCare.gov website promptly on September 13.  I know, it didn't go into effect until October 1, 2013, but I was anxious.  At that time, there was but a single insurance company in the bustling marketplace and since easily distraught, I became distraught.  Which led me into the arms of a very nice, calm, optimistic "navigator" -- our helpmates through this process -- Bill Rencher of Georgia Watch.

[Four Ruffles and Fluorishes for him, too!]

Since 1 October, I've been pestering the website dozens of times a day and receiving nothing but the the most polite error messages ever seen in cyberdom.  Repulsed, refused, unrecognized, I had about given up hope, despite the reassurances that the bugs in the system were slowly but surely being smushed into little bug pieces.  A carapace here, long sticky legs there, bulbous eyes strewn about.  Exoskeletons piling up, and with the government shut down, no one to sweep up the entomological detritus.  I say send 'em all to "Cry Me A River" Boehner.

Usually, Mr. President, I give no hints as to my political persuasions.  Yes, I used the plural, for like Whitman I contradict myself, I am large, I contain multitudes.  Ahem.

This morning, at 5 am, revolted by the idea of getting up to do something profitable for the domestic brood around me, I grabbed the computer and hit HealthCare.gov with something like a vengeance, but definitely with weepy eyes and no coffee.

After diddling around a bit, I created a new profile, ditched the old one, and kaboom, shazaam, wowza -- I was in!  Then I screwed up and had to call one of those blessèd telephone helpers, who was also confounded but wished me well.  I think, Mr. President, that she ended up helping out somehow, for a mere half-hour later, the glitch slid into the background of things.  It didn't disappear, but I was able to navigate from screen to screen and ignore the hell out of it.

Navigator Rencher, who helped calm the waters in September, had made several predictions about what my best options might turn out to be, coming from the Affordable Care Act's PCIP program, which ends precisely on 31 December.

He was right on all counts.  If I take up gambling, I'm bringing him with me to the racetrack.

If I could sneak past the First Lady and give you a prim kiss on the forehead, I'd do it in a heartbeat.  But what with all the shooting going on up there, they'd drop me with a head shot, for sure. (Gun control, anyone?  No destruction of the Second Amendment, just no guns for crazy people, registration and permits for all, no assault weaponry or accompanying ordinance, and equal restraint from law enforcement, including the Secret Service and Capitol Cops)

Since I doubt you'd break out into any Al Green on my account, I'll just say this here, in the safe haven of a nondescript blog:  God bless you, and thank you, President Obama.  I am a person with loads of physical woes that are constantly ganging up on my meager finances and limited sanity -- I worry, you see.  I don't want to be a victim, or whine about entitlement.  I don't want to bankrupt this good country.  But damn it, I need help.  My entire work life was dedicated to turning out well-educated citizens, both at university and at the proverbial "urban" high school level. I put my life at risk substitute teaching for the little ones, too, those cagey rug rats!  And I worked in Middle Schools where my status as a rube spread like wildfire, and the tweens often had me cornered between desk and blackboard, forcing me to throw chalk and lob erasers as a distraction.

In all seriousness, I had my life threatened and a student broke my hip in an attempt to escape capture by the kind and courteous police-people chasing him.  When I came back to work, one of my homeroom seniors stole my walker. To this day, I am convinced he was simply finding a novel way to encourage my physical therapy progress...

I was a GREAT teacher, Mr. President.  I loved my subject, I instilled a love for it in whomever the registrars put before me, and my students reveled in the concept of critical thinking and superb writing.  I'm just sayin'.  But these days, living on 60% of my year 2000 salary, no adjustment for the crazed costs of living, I need a little help.

Ted Kennedy would be bear-hugging you about now.

That website is going to drive many a USAmerican bonkers.  People unfamiliar with the terminology and the mathematics of health insurance are going to be breaking the backs of the Emergency Departments around the country as their heads begin to explode. I hope that was worked into the cost analyses.  But, like me, they will figure it out.  They will work with the outstanding navigators in their area, the phone wizards with infinite patience, and the online tech folk who speak plainly and make real suggestions -- even if those suggestions are initially aggravating.

I am now insured -- including a separate basic dental policy -- for less than what ACA's PCIP (a wondrous creation, that!) was charging. There's a whopper of a deductible awaiting me, and some nasty negotiations over medication formularies, and a doctor to switch out (but I've been secretly wanting to lose his Hoity-Toity-ness for some time, anyway).

And then there's the fear that this is all a dream.  That I filled something out wrong.

If I could throw chalk at a few Republicans for you -- I'd be up there in a minute.  But again, Mr. President, I don't want my pedagogical corrective measures to be misconstrued as some sort of attack, thereby ending my entretien with the GOP by a bullet square between my eyes.

Anyway, thanks.

You've done a great thing.

Sincerely,
Me and all the Gang at Marlinspike Hall
Tête de Hergé
(West of the Lone Alp)

P.S.  Should you and your family ever need access to an unmappable, unflappable resort that is impervious to GPS systems, Captain Haddock has ordered us to keep one of our finest wings ready.  He has even offered to ferry you here past the sharp eyes of your protective service, courtesy of an inexplicable undersea network of blackholed miniature submarine passages, all of which end nicely in our moat.

P.S.S. I decided to repost, just under this new letter to you, an older one, so as to aggrandize the scope of my experiences with obtaining heatlh insurance under your administration.  Let's call them bookends.  There are other mentions of you throughout this blog, as you've probably surmised.  My apologies for some of them.  There is even a shot of you in a video made at one of my lowest moments, but even that connection made for a "sí, se puede" rallying cry.




© 2013 L. Ryan

Friday, October 5, 2012

Paul Krugman on Romney's Sick Sense of Humor



Romney’s Sick Joke
By PAUL KRUGMAN
Published: October 4, 2012


“No. 1,” declared Mitt Romney in Wednesday’s debate, “pre-existing conditions are covered under my plan.” No, they aren’t — as Mr. Romney’s own advisers have conceded in the past, and did again after the debate.


Was Mr. Romney lying? Well, either that or he was making what amounts to a sick joke. Either way, his attempt to deceive voters on this issue was the biggest of many misleading and/or dishonest claims he made over the course of that hour and a half. Yes, President Obama did a notably bad job of responding. But I’ll leave the theater criticism to others and talk instead about the issue that should be at the heart of this election.

So, about that sick joke: What Mr. Romney actually proposes is that Americans with pre-existing conditions who already have health coverage be allowed to keep that coverage even if they lose their job — as long as they keep paying the premiums. As it happens, this is already the law of the land. But it’s not what anyone in real life means by having a health plan that covers pre-existing conditions, because it applies only to those who manage to land a job with health insurance in the first place (and are able to maintain their payments despite losing that job). Did I mention that the number of jobs that come with health insurance has been steadily declining over the past decade?

What Mr. Romney did in the debate, in other words, was, at best, to play a word game with voters, pretending to offer something substantive for the uninsured while actually offering nothing. For all practical purposes, he simply lied about what his policy proposals would do.

How many Americans would be left out in the cold under Mr. Romney’s plan? One answer is 89 million. According to the nonpartisan Commonwealth Foundation, that’s the number of Americans who lack the “continuous coverage” that would make them eligible for health insurance under Mr. Romney’s empty promises. By the way, that’s more than a third of the U.S. population under 65 years old.


Another answer is 45 million, the estimated number of people who would have health insurance if Mr. Obama were re-elected, but would lose it if Mr. Romney were to win.

That estimate reflects two factors. First, Mr. Romney proposes repealing the Affordable Care Act, which means doing away with all the ways in which that law would help tens of millions of Americans who either have pre-existing conditions or can’t afford health insurance for other reasons. Second, Mr. Romney is proposing drastic cuts in Medicaid — basically to save money that he could use to cut taxes on the wealthy — which would deny essential health care to millions more Americans. (And, no, despite what he has said, you can’t get the care you need just by going to the emergency room.)

Wait, it gets worse. The true number of victims from Mr. Romney’s health proposals would be much larger than either of these numbers, for a couple of reasons.

One is that Medicaid doesn’t just provide health care to Americans too young for Medicare; it also pays for nursing care and other necessities for many older Americans.

Also, many Americans have health insurance but live under the continual threat of losing it. Obamacare would eliminate this threat, but Mr. Romney would bring it back and make it worse. Safety nets don’t just help people who actually fall, they make life more secure for everyone who might fall. But Mr. Romney would take that security away, not just on health care but across the board.

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Monday, September 10, 2012

Dear President Obama...



Mr. President:

I learn something new every day.

I'm one of your avid supporters, President Obama, and someone who has benefited enormously, albeit catastrophically, from the Affordable Care Act, most specifically the Pre-Existing Coverage that was made available for me to purchase.  (An aside -- in your campaigning, it would help people to understand PCIP better if they knew that it was not "welfare," that enrollees pay their way.  However, I confess to having blown, all by myself, the national budget for this program, and it is only September!)

I'd be even more avid in my support if you'd push for real and true reform in your next term in office.  That's right -- the public option, true universal coverage, deep, real reform.

But there is also in me a conservative streak, though I prefer to consider it basic common sense.

The medical details are irrelevant in this story of abuse of the health care payment system:  On July 10, 2012, I required emergency transportation from a doctors' building to the emergency room of the hospital across the street.  Well, to call it a "street" is a stretch, since it was more like an alley.

There was no need, as there was no time, for even the taking of basic vital signs, no i.v.s started, nothing. They just put me on the stretcher, took the elevator down to the ambulance, loaded me into it, crossed the alley, and delivered me to the emergency room.  In the interim, they managed to muck up information such as the office we had come from and the reason for the emergency transport.  (The guys said "dislocated shoulder";  In actuality, it was sepsis.)

Because I have passed the catastrophic limit for the year, most of my medical charges are being paid at 100% by PCIP -- for which you have my deepest gratitude.

I still make it a habit, however, to peruse each and every Explanation of Benefits form that comes my way, and there are some almost every day.  It's been that kind of decade.

The EOB for the ambulance ride arrived in today's mail.  PCIP payed them a whopping $963.00, exactly what they billed.

I thought about ignoring it.  Why should I care?  I'm at 100% coverage, my health is "catastrophic," and I had just spent two hours convincing a radiology practice that they would likely get paid if they would file with PCIP and not the insurance company I had four years ago.  But, still, I found myself reaching for the phone.

The first two times I dialed and explained why I was calling, my call was disconnected during the complicated transfer to the billing department.  The third time, I think the Obama-like steel in my voice made the call go through like magic.

I discovered that a nifty way to inflate an ambulance charge is to alter the address of origin for the "pick-up" or rescue, or whatever they choose to call it.  The Big Ride.

My home address was "inadvertently" listed as the originating point of the ambulance ride across the alley. My home address, of course, is in a different city -- not too far away, but still...

Call me a cynic, or nuts (though you'll not catch me conversing with an empty chair), but I suspect this inadvertent confusion of addresses happens with some frequency among the shadier members of the rescue community.  I suggest that anyone taking The Big Ride and facing a huge bill as a result obtain the paperwork designating starting and ending points.

They're going to "investigate" my claim.  I asked them to please reimburse a goodly amount of that charge to PCIP.  I'm doing what I can, President Obama!

I hope your ribs are okay -- I saw that tremendous bear hug you got at the pizzeria this morning!  Good thing you didn't need an ambulance!

Your supporter,
Profderien