Put the Love Back

It will surprise no one that my Tuesday rant today will talk about the health business.

I'm not talking specifics, I'm talking about the state of the whole affair. Because our "health care" is no longer about HEALTH CARE. It's about money.

Anyone who says otherwise is fooling themselves. Of course there are individual doctors out there who care very much about their patients, and who are working diligently to help. But they also see that the system is broken. I know this because some of them have told me so. That's one of the good things about being a reporter; you hear stuff. I know how to ask the right questions.

Wellness models would work much better, and that is what we should be working towards. We need more dieticians, nutritionists, and mental health therapists. We need folks who make calls and check up on people.

We need to put the love back in the system, and take out the greed.

I have tried many different ways to take care of myself. Some of those are non-western medicinal modes, such as acupuncture, Reiki, and Tai-Chi. I also like physical therapy (western style) and chiropractic care as healing modalities. I have found some benefit from all of them at various times. I prefer all of these to a traditional doctor's visit at a big facility (I do like my independent and feisty primary care doctor). However, western medicine has its place and can be useful. You can't heal a broken leg with acupuncture, after all, though you can certainly help it heal better.

The problem is, those types of healing modalities aren't quick fixes. We all want to be better in the next minute. We can't miss a day of work, after all (gosh, there's that money thing again). Hence the "pop a pill" mentality. Or the "blast it with chemo" mentality. Sure, these might work, but I have to wonder at what cost - not monetarily, but health-wise. What are we doing to ourselves?

I think diet changes would fix a lot of health problems, not just for me, but for the large majority of the population. If we have to have a nanny state to bring people back to good health, I don't have a problem with that. Outlaw big milkshakes and force the food suppliers to come up with safe ways to preserve products. Make sure every single additive in a food source has been tested, and not by the company that wants to use it, but by an independent laboratory. Our food should not be poison. I suspect a lot of it is.

When I was having a major surgery a year there for six years, back in the late 1980s and early 1990s, I found the best health care came not from the actual surgery, but from the healing hands of the nurses who soothed my brow and encouraged me to get out of bed by holding my hand, putting an arm around me, or gently touching my knee on their way out the door.

Touch is, I think, one of the most underrated healing modalities out there. We all need more of it. Go get a massage!

I am quite concerned by the lack of follow-up from western medicinal facilities. I have a friend with breast cancer who stopped going to her oncologist and switched her care to her breast surgeon (the oncologist office made her cry every time!). But the oncologist's office never once bothered to call and see if she was okay, if she was receiving treatment, etc. I know people have the right to refuse care, even to chose to die from what is ailing them, but somebody ought to at least make a phone call.

This cold callousness is going to be the death knell of the health business in the U.S. I predict people will turn more and more to alternative methods - and unfortunately to some of the quackery things that were predominate in the 19th and early 20th century (which will only make things worse) - if the health business in the US doesn't actually become true HEALTH CARE.*



*This has absolutely nothing to do with the Affordable Health Care Act. Health care had become a health business long before that became law. Just so you know.*

Carilion Makes Good

A few days ago I wrote a post about how a Carilion doctor basically left me stranded regarding my health care when I went for a second opinion on a chronic health issue.

The post was not very complimentary of Roanoke's largest health care provider. Nor should it have been; what happened was inexcusable. I also linked the post on my Facebook page.

What happened next was completely unexpected. First, my Facebook friends, many of whom had no idea that I have been so ill because I've been somewhat private about it, came to my defense with concern and indignation. Some shared stories of their own issues with our behemoth healthcare system, including the local providers. Others offered up prayers. My inbox filled with suggestions. A few people posted helpful links in hopes of helping me figure out the source of my chronic pain. I was incredibly humbled, grateful, and overwhelmed by this outpouring.

On Thursday morning, around 9 a.m., I received a call from a Carilion representative. She said she'd heard I had a bad experience with Internal Medicine and was following up. I told her what had happened. She said that was not acceptable and that she would get me in to see an internal medicine doctor that very day.

She called back in about 20 minutes and asked if I could be at the Riverside facility for a 12 p.m. appointment. I said I would be there.

Then the most surprising thing of all happened: I received an email from Nancy Agee, President and CEO of Carilion. Ms. Agee said she was saddened to learn about my bad experiences with Carilion and that she wanted to help. She said she had taken action internally right away.

I received her note right before I left for my new appointment. I met with a different internal medicine doctor who was very kind. The nurse was nice, and the head of nursing for that department came in and apologized to me for the treatment I had received the day before. She told me that the issue had been corrected and that in the future people would not be treated as I was. I am very happy to report that and I hope that is indeed the case.

After our consultation, the doctor said the staff had already arranged for me to have a meeting with a gastroenterologist on Friday morning (4/25) if I wanted the appointment. I did.

This morning I met with my new gastroenterologist. He was a very nice doctor, quite thorough, and keenly interested in helping me understand why I am in so much pain. For the first time in all of my many doctor visits, this doctor took the time to pull out an atlas of the human body, show me how all the organs intertwined, point out the locations of my muscles, and show me where I hurt.

After my consultation with him, I had a much better understanding of the problem I am facing. My healthcare issue is an unusual and complicated one. The fact that the pain has continued for so long makes it especially difficult, he said.

He gave me a new drug and said he was hoping that with medications and physical therapy, I would be about 60 percent better over the next few months.

That is not exactly the news one wants to hear, but I think I could function at 60 percent better. Certainly I could function better than I am now.

So Carilion made good and stepped up to help me. I am very grateful to Ms. Agee for her intervention, and most especially grateful for my unknown Facebook friend or blog reader who sent her the link to my page. I am glad to know that the leader of our largest healthcare provider does take an active interest in seeing that people are treated fairly. I hope that, at least, what happened to me will cause a change so that others are not left uncared for.

Truly I hope that the 9 a.m. Thursday phone call from a Carilion representative would have happened anyway; that someone would have realized there had been a mistake, and set out to make it right, without a command from on high. I don't know the sequence of events, except that I did receive the phone call from the rep before I received the email from the CEO. *Updated: I have since learned that the initial call to me to correct the problem was implemented prior to the CEO learning of the issue. So good for Carilion.*

And now, while I have it on my mind, I am going to list a few concrete things I'd like to see Carilion do to make itself a better healthcare provider for Roanoke. Some of these perhaps could be wrapped up into a new program called CarilionCares. That has a nice soothing ring to it, doesn't it?

1. Put a link to a (I am making this email address up) complaints@carilionclinic.org email (or something similar) in a prominent place on the front page of the main website. Presently, the only contact information goes to something called direct@carilionclinic.org and you don't know if you're writing to a person or a dead email file. I did receive an acknowledgement of the email I sent out Wednesday afternoon, but I think a cheery little box that says "Have a complaint? We want to help! Write us!" would go a long way. One of the most frequent comments I had on my Facebook page and in private messages was that people felt like their problems with healthcare at Carilion were going unheard.

2. Establish a better referral system. The Doctor/Provider section on the website lets you search by name, specialty, or location. But what if you don't know what specialist you need? How do you find out? That is where I ran into problems. I had no idea what kind of specialist I needed. Ideally, the primary care doctor would make a referral, but that isn't always the case. Sometimes you have to take matters into your own hands. The more power a person has to do this, the better for all. There should be a way to email a CarilionCares specialist asking for advice on the best doctor, or a way to call said specialist and ask for a referral. That specialist should be able to determine some direction for the poor soul on the other end of the phone. That specialist should be familiar with as many doctors and specialties as possible. If I called in tomorrow saying "I want a no-nonsense female doctor who can help me with the pain in my hip," she should be able to say, why of course, Dr. So-and-So would be just right for you. And that shouldn't just be platitudes, but a genuine effort to match patient and doctor.

3. Have better follow-up. My health insurance provider offers me something called "conditioned care" and a 24-hour nurse line. I have taken advantage of both - but they aren't located in Roanoke. They can't advise me except in the most general of terms. However, they check with me about my condition, ask appropriate questions, and offer help in other ways if I need it. Shouldn't someone from Carilion follow up when a patient diagnosed with asthma or high blood pressure or some other chronic issue doesn't return as scheduled? Make sure they're taking their medication? If a healthcare facility truly cares about its patients, then it should not lose them in the day-to-day matters. At the least, how about a 24-hour hotline for people with questions and concerns to call? If my health insurance provider can do that, I don't see why Carilion couldn't do it for its patients.

4. Have patient advocates for people with chronic and life-threatening conditions. For example, I remember when my mother was diagnosed with pancreatic cancer how alone I and other family members felt. There was no one available to guide us through the process of my mother's dying. I have felt a similar sort of panic with my own health care issue and it would be nice to have someone to call, if nothing else for a little reassurance.
Family members and patients get scared - it's a tough time when someone is sick. Kindness never hurts.

I think some of these things may already be in place - they're just not highly visible. There are volunteer opportunities on the webpage but it's hard to locate; I had to hunt for it. Shouldn't these people be promoted - maybe they should be the face of the healthcare community? I would urge Carilion to consider these types of nurturing activities - along with others - so that people can see that the big healthcare provider is there for them as people, not as dollar bills.

Why I Dislike Carilion

I had a long-standing scheduled appointment at 9 a.m. with an internal medicine doctor at Carilion's new Riverside facility this morning (4/23/2014). I had called back in February and asked for assistance in finding a doctor, explaining I was having stomach issues, and was directed to Internal Medicine and given this appointment by someone at Carilion's appointment desk. I asked specifically if this doctor would be a good doctor to see for my issue and was told "I don't know, I just make appointments."

 

Anyway, I kept the appointment. An internist should know about your internal organs, after all, and that is where I am having problems. After I arrived and paid my co-pay, the nurse called me back to the examining room. Then she asked me if I was looking for a new primary care doctor. I said no, I was there for a specific issue, I have a primary care doctor whom I like and I wasn't interested in switching. However, my primary care doctor had encouraged me to seek help elsewhere because her months of assistance have failed to alleviate my problem.

Then I was told that unless I was switching to this internist as my primary care doctor, she wouldn't see me. I asked if she would see me this one time - I even offered to pay the specialist co-pay - and I was turned away!

 

I sat sobbing in the examining room while the nurse went out. Another came in and said the same thing. My husband was livid. I went sobbing out into the waiting room where at least I was refunded my copay. However, I am in so much pain and have been unable to find a doctor to help me. What is wrong with a health care system that doesn't bother to alleviate suffering?

Obviously, Carilion's health care system is not set up in the best interest of the patient AT ALL and I find it to be the most appalling method of taking care of people I have ever experienced. Apparently all they care about are profits.

I do not understand why I couldn't be evaluated and looked at for referrals or whatever I needed instead of sent away crying in pain. This callous doctor, her nurses, and this entire organization should be ashamed of itself for what I experienced this morning. I can't believe any health care organization would turn away a patient - a paying patient with good health insurance, I might add - over some stupid policy such as this.

 

It is no wonder people leave this valley to find medical care. You certainly can't find it here.

 

When I had my gallbladder out last summer, it was at Carilion Hospital. You might want to read my blog entry about that, appropriately entitled A Comedy of Errors. It reads like a horror story. And I've been sick ever since - 10 months. Ten months solid of pain and nausea.

 

I don't know how this hospital organization receives any of these awards they tout. It can't be because they ask the patients what they think. Or maybe the patients are afraid to say because they fear they won't get care.

Well I am not afraid of the big bad behemoth of Roanoke. They owe me an apology, if nothing else.

Watch Me Glow

This morning, in about 20 minutes, actually, I am going for a CT Scan.

This will be the second one I have had. The first I had in the emergency room in September. This one should be a little less nerve-wracking, given that it isn't in the ER.

I continue to have severe abdominal pain that doctors so far cannot diagnose. It is everything from nothing to ulcers to muscle spasms to some kind of "pelvic floor disorder," depending on the doctor and his or her specialty. But so far no one can help.

Some days the pain and nausea are so bad all I can do is get up, maybe sit at the computer a while, and go back to bed.

So I don't know whether to hope this test shows nothing or something.

CT Scans involve drinking 32 ounces of something that doesn't taste very good. Then they use some kind of contrasting agent through an IV and run you through a scary-looking machine. It is round and it takes pictures of your insides "in slices," as my general physician described it.

Anyway, wish me luck, however it turns out.

Thanks for reading.

Update 12:05 p.m.

It was a difficult procedure. First you have to drink 32-ounces
of liquid that makes your stomach cramp up. Then you have to spend over an hour and have three people stick needles in you 10 times to try to find a vein. Then you have to try to stand up, after being stuck in a chair for that hour and getting stiff. Then you hobble over to the machine without moving your arm for fear the IV will pop out. Then you have to hold your breath for up to 10 seconds at a time while you are moved through the machine. Then they insert the stuff into the IV and it makes your nose, mouth and groin area feel like it is on fire. Then you go back into the machine a few more times. Then you sit up and they take out the IV. Then you squirt blood all over the room and they wrap a compression bandage around your arm to stop the bleeding. Then you hobble out to your long-suffering husband and beg him to take you home.

Or at least that is how it happened to me.

Health Update

I try not to write too much about what is going on with my health because I think most people find it boring or don't really care, but for those who have wondered:

I am still having pain that doctors think is from adhesions from my gallbladder surgery. This is a relatively rare complication but not unknown. However, the pain is fairly severe and chronic. Last week I started physical therapy to try to stretch things out in hopes of avoiding another surgery. Fingers crossed. If surgery is required, I will likely have to go out of the area to find a specialist who deals with adhesions.

I was also having trouble with fatigue and nausea, which I attributed to the pain. My family doctor sent me to a gastroenterologist to be sure, though. After some testing on October 31, I learned that I have many, many ulcers (more than 50!) in my stomach and small intestines, and erosion of my esophagus. I am taking medication for that and hopefully it will help with some of the multiple issues I have been dealing with.

On the plus side I have stuck with Weight Watchers Online and I'm still losing weight, although rather slowly. I am not able to be very active because of the abdominal pain (which increases with movement) but hopefully the physical therapy will help.

I have felt less tired in the last week, so I am hoping that clearing up the ulcers will bring improvement.

Thank you if you've been thinking of me and wishing me well.

Think of Me Tuesday

Well, dear readers, as you may recall, I noted a while back that my gallbladder surgery did not go as planned.

I was supposed to jump off the gurney and race my husband home, and fix him dinner, within about two hours of the surgery, and in six weeks time I was supposed to be feeling like a million bucks.

That did not happen.

While I don't know that anybody actually jumps off the gurney and goes on with their life right away, I do know that a lot of people apparently do much better after surgery than I have. I know one woman who had gallbladder surgery in mid-September and she is already back to doing Zumba. She's about 15 years younger than I am, but still. And there's another who is about my age who had surgery within days of mine, and she was out riding horses about five weeks later.

Yesterday I forced myself to go out to the Open Studios event and visit three artists' studios, all friends of mine. It was all I could do to manage that. Everywhere I went, people told me I did not look well.

To be honest, I can barely push a buggy around Kroger and it's been four months to the day since my surgery. I am in a great deal of pain and obviously something is wrong. I wasn't the healthiest person to start with but I wasn't in such bad shape that I should have degenerated to the point that I have.

Today I am finally seeing a specialist who may or may not help. I have no idea what I will be told - I can tell you I have thought up about a million things that could be wrong with me, none of them particularly pleasant. I am hoping that the reality is not as bad as my fertile imagination has sometimes led me to believe.

Anyway, if you are one of those folks who prays, or thinks nice thoughts, or lights candles, or crosses your fingers, or just offers up a little hope when someone you know is having a tough time, I would appreciate any of those good things.

Many blessings to you all.

This Is What They Tell Me

They tell me I am not dying, anyway.

The "they" being a number of doctors I have seen in the last six weeks.

I have been quiet about it, but my gallbladder surgery has had complications. Or at least, the after-effects of the surgery have certainly complicated my life.

The pain is nigh unbearable in my right side at times. Other times it is just an ache, but it's always there.

It hurts to walk. It hurts to move up and down. I have nausea and no energy.

Early in September I spent a day in the emergency room again. Initially they thought I had appendicitis, but finally decided I didn't. They gave me pain killers and sent me home.

One doctor has diagnosed me as having a rare occurrence, something to do with nerves and scar tissue which interfere with the abdominal muscles. His theory is that the muscles clench up like when you have a Charlie horse in your calf muscle, only they kind of stay that way. And it's in your belly, not your calf.

Muscle relaxers have helped, but just a little, and I have to keep taking them. They make me dopey and slow.

To say this has become life-changing is an understatement. It is tough to focus when your belly hurts. I've had to stop exercising, which makes other body parts hurt - I need to move, after all.

The worst part is no one can say that the diagnosis is right, or how long this might last. That's scary, for sure. What if it never stops?

They tell me I am not dying, but I have to say it kind of feels like it sometimes.

Magic Pills

When I was a child, so very long ago now, my brother, my young uncle, and I would pretend that we had magic pills.

Generally these were either M&Ms - usually the red ones - or a Smartie. Smarties are sugar candies that come in rolls of pastel colors, information I add because it seems to me not everyone eats these.

Anyway, I think the purple Smartie was the ultimate "magic pill" in our play.

Rather like Alice when she would drink something, the "pills" would "change" us somehow - make us smarter, or able to leap from tall buildings (which meant jumping from a chair with a towel for a cape). I think I usually went for the "make me smarter" pills, leaving the cavorting to the boys. I think I fancied myself the smart one, sort of like Velma in Scooby Doo.

We also took a children's multivitamin, which I remember as Flintstones even though they weren't around until 1968 according to Wikipedia. These were also magic pills, handed out daily by my grandmother, who kept my brother and me until we began school, and then again during the summers. Grandma would give us the vitamins and we'd run around like crazy superhuman beings for about five minutes afterwards, because the "magic" had to wear off.

So even back in the 1960s, the hunt was on for the magic pill. These days, here in my golden years, the magic pill would be the one that cures the asthma, eases the allergies, halts the pain. And there are no magic pills for those conditions. Most medication is really some kind of poison and side effects can be killers. It is something to keep in mind.

My mother believed that doctors could fix everything, and she gave me whatever they offered. That was frequent because I was a sickly child. I am fairly certain that up until I was married, I had imbibed in every antibiotic potion known to mankind. That is no longer the case, thanks to new drugs that I eschew and to a mindset that I keep that says "buyer beware" when I am offered a new drug.

Even so, I take far too many medications. I don't search for the happy pills, or the smart pills, or the weight loss pills, but the doctors have handed me instead blood pressure pills, thyroid pills, and allergy medication that I take year-round. Here a drug, there a drug, everywhere a drug drug.

None of them are magic pills, little round droplets that cure what ails me. They may help or control but they aren't fixes. Medication seldom fixes or cures, I fear. I'm not sure that anything does.

This morning as I took a 30-minute walk on the treadmill I was thinking of those times so long ago when I was naïve enough to think that just by believing it I could make an M&M be the magic pill that would make me smart. I learned long ago it takes hard work and lots of study to increase my knowledge. It takes hard work and lots of sweat to make a body healthy (something I am still not very good at). Pill-popping is a long-lived habit that I wish I had never learned.

This also came to mind because I have been reading that even Tylenol isn't safe. I have long known it could damage your liver and have been judicious in my consumption of that particular drug, but as I age I suspect I will be taking more of it. I don't tolerate the NSAIDS or aspirin, and that leaves acetaminophen. I'm not sure what has made the drug a topic for discussion all of a sudden, but it doesn't bode well for a pain-free old age.

I wonder if I tossed some magic M&Ms in the air, and made a wish, if anything would change.

Thursday Thirteen #305

Things you should know about your food (but probably don't want to know) . . .


1. Shredded cheese, so easy for salads and soups (and definitely quicker than hauling out a block of cheese and a grater) is coated in something called cellulose to keep the shreds from sticking together. Cellulose is made from wood pulp. Yep. Your shredded cheese is covered with sawdust from a giant redwood or something.

2. Cellulose is also used in many low-fat items, including ice cream. Check the labels. My Weight Watchers one-point low fat ice cream is really a branch of a tree.

3. Aspartame is said to be perfectly safe, but I think it is akin to rat poison. Here is a pro-aspartame website. It will tell you how wonderful it is. Here is a website that tells you how terrible this drug is. It lists 92 different problems that aspartame can cause, including MS, lupus, cancer, vision problems, and death. Personally, I think this is a loathsome chemical, foisted on the public, oddly enough, by Donald Rumsfield (check this FDA site for some interesting comments about this). Call me a biased liberal, but I feel sure that anything Rumsfield had a hand in simply cannot be good for me.


4. Saccharin is a sweetener drug that has been around well over 100 years, but it has only been on the market since 1977. That's when Congress overrode the FDA and forced it to approve it. Check it out at this FDA website. Trust those folks on Capital Hill, yes? Saccharin is believed to cause cancer.


5. MSG can be found in these ingredients: yeast extract, torula yeast, hydrolyzed vegetable protein and autolyzed yeast. You'll find those ingredients listed in thousands of foods, but they won't mention MSG. That includes soups, etc. that claim to be MSG free. They aren't.

6. Splenda is sucralose, and it leaves a taste like chlorine in my mouth. I couldn't figure this out until I looked up stuff about it, and discovered it is sugar turned into a chemical that is, guess what, chlorine. Go to http://splenda.com for the corporate smiley site about it if you want the Disney spiel. This sweetener also supposedly causes thymus problems and possibly cancer and other health issues. It has become quite popular at a very alarming rate. At least it is alarming to me.


7. Aside from sugar, Stevia the sweetener that I think is the best to use. Stevia is about 300 times sweeter than sugar. It supposedly has been used for 1000 years in Paraguay. The FDA cracked down on it in 1995, apparently at the behest of the sugar industry, and Monsanto (Monsanto is a giant food company that apparently exists to make money from foods, regardless of the potential for poison, for anyone who doesn't know that, which I suspect is many Americans).
Stevia is now widely available in the U.S. Information on side effects is conflicting and it depends on who sponsored the research, of course. Research by the aspartame companies shows it is bad; stevia sellers say it is good. I would not use Truvia, which is a sweetener derivative of stevia. I found one site that says that stevia makes your body process sugar a lot quicker. At http://sweetleaf.com there is some information, but it is a corporate site and doesn't say much. It does say there have been 1000 tests and it's found to be safe. Japan apparently has banned most sweeteners except for stevia and sugar.

8. Plastic food packaging seep chemicals into your food, particularly bisphenol A. When you cook in plastic containers, the exposure to the chemical is increased. Bisphenol is a hormone disruptor and can cause breast formation in men and severe hormonal imbalances in women. It may also encourage hormone-related cancers such as prostate cancer and breast cancer. See Plastics chemical bisphenol A found to promote prostate cancer in animal studies.

9. Love your Greek yogurt? During production, companies create a whey product that no one knows how to get rid of. It's toxic and has caused fish kills by the thousands when illegally dumped in streams and lakes.

10. That expensive extra virgin olive oil you're using because it's supposed to be so healthy for you - probably isn't. It probably isn't even olive oil. Many of these oils are cut with cheaper seed and nut oils.

11. That lovely red color of your favorite ketchup, including m husband's favorite, Heinz, comes from crushed bugs. Red- and pink-colored products are often dyed with cochineal extract, also known as the bodies of crushed-up little insects. Cochineal extract is also listed as carminic acid or carmine. The bugs come from Mexico.

12. No cream in coffee creamer. Those non-dairy coffee creamers have lots of sugar, a little kelp carrageenan), and some other stuff.

13. Carrageenan, which is a seaweed, is often used in ice cream.


Thursday Thirteen is played by lots of people; there is a list here. I've been playing for a while and this is my 305th time to do a list of 13 on a Thursday

The Shame of U.S. Healthcare

The lie of healthcare in the United States needs to come to an end. All of my life I have heard how we have the best healthcare in the world. How anybody who wants healthcare can have it, and if you don't get the care you need, it's nobody's fault but your own.

I call bullshit. Actually I call double-deep bullshit, bullshit up to the wazoo.

In today's Roanoke Times, there is a story about the free clinic in Wise County. Thousands of people - yes, THOUSANDS - venture to this weekend event to have their teeth pulled, their eyes checked, warts removed, or have other ills, some quite serious, taken care of.

Most of these people are uninsured or underinsured. They have lost jobs. In the most devastating turn of events, they once worked but had an accident or illness and lost their job, and thus their healthcare, right when they needed it most.

I find this completely unacceptable in a country as wealthy as the United States. This is the kind of stuff you expect to see and hear about in some unknown small nation in some forgotten third-world country. But this is here, in Virginia, in the USA. Right down the road.

But even if you have insurance, you're not home free. It is estimated that at least 60 percent of all bankruptcies filed in the U.S. are due to exorbitant health care bills. That is over a million people a year who become ill and need care, but can't pay for the help they need.

Plus the insurance companies (not the government, now, the private insurance companies) have allowances - you're allowed so many visits to the chiropractor, so many visits to the eye doctor, so many visits for this or that. If you're someone who needs more visits than the policy allows, you either don't go or you pay for it yourself. In that case, you're underinsured.

On top of this, the insurance companies and the medical communities have this interesting con game going on wherein the medical facility or doctor bills at one rate, but will accept a lower rate from the insurance agency. Some doctors require the patients to make up the difference, but many do not. Why is there not one rate? Why does it cost the insurance company one amount but the person who pays cash another? How is this even considered to be anything other than dishonest and some kind of scam?

I have a high copay for doctors who are "specialists" - which is every doctor but my family doctor. To my mind, that high copay is enough for a visit, but the doctors charge more and more on top of that. For example, in May I went to see a specialist about pain in my foot, and the bill sent to the insurance company was for $684.00. The insurance company actually paid $480.00, I had already paid my copay of $40.00, and later I received a bill for an additional $28.00 for something that the insurance company said was "allowable" but they didn't pay. I have no idea what happens to the difference in there. Or why one thing is "allowable" and something else is not.

Not only that, but the charges for health care are nothing short of obscene. Take a look at this:

$12,913 - hospital (pre-op, operating room, post-op, a room for about 16 hours)
$ 2,182 - surgeon charge
$ 1,045 - anesthesia charge
$ 2,760 - initial emergency room visit
$   882 - emergency room doctor
$   138 - visit with my family doctor (as instructed by ER)
$   100 - radiology
$    85 - pathology
$   200 - what the urgent care facility charged to tell me they couldn't help me and I should go to the ER

Total (so far): $20,305.00

These are the charges for my gallbladder removal, starting with my initial visit to the urgent care (because I didn't want to go to the ER and the urgent care is supposed to be cheaper for everyone; I didn't know I would end up needing surgery). If we didn't have insurance, we'd be declaring bankruptcy along with the other 1.5 million people who will do that this year, I imagine, as we simply don't have that kind of money under the mattress. But we are fortunate - I am fortunate - and have health insurance, which we pay for to the tune of about $8,000 annually - just for me. His employer pays most of his share.

The health insurance company will not pay out $20,305, though that apparently is the amount a person with no insurance would be expected to cough up.

No, the health insurance didn't "allow" all of those charges and instead will pay out less than half of that amount. My share will end up being around $1,000, I think. I'm still waiting on all the bills to come in and I'm basing that on the "allowable" charges. It could be more.

The reason I am so fortunate to have health insurance is because my husband has a decent job, the kind that are becoming scarce. I made a good choice in a mate and he has taken care of me. I have had multiple health issues over the years and while I have always worked, at times I have had to leave jobs or change jobs to accommodate health care concerns. I have been lucky that I had a husband who could work a job that offered decent healthcare. But not everyone has this opportunity, and not everyone can work and keep their healthcare.

You shouldn't be punished and lose everything simply because you're sick. I see people in our area who have to have fundraisers for cancer treatment - they hold square dances or bake sales or something. Who thinks that this is okay? It is not okay with me. I think it is about the saddest thing I have ever seen, and it should be a major condemnation of what is going on in this country. Every time I hear about one of these events I cry.

I personally am glad we have made changes in the healthcare law because the system is incredibly broken, but I don't think the changes implemented under President Obama go far enough. They do not fix the issue but instead were a gift to the insurance companies. I don't know that prices will decrease, or that quality of care will be improved.

A true change in healthcare would involve building hospitals, training people, and ensuring that we have the infrastructure we need to take care of people. Without that in place we have no foundation upon which to build. Stimulus money should have gone to those types of projects immediately, but of course it did not.

It looks to me like everything needs to be changed, from the way medical charges are billed to payouts to claims. A complete overhaul.

I want a New Deal, one that helps everyone. People should stop bitching and moaning about the upcoming Affordable Health Care Act and instead try to make the damn thing work.

All Hail Liz

My husband watches a show on the History Channel called Swamp People. This means that I watch the show, too, because our nightly routine is that I sit beside him and read while he flips channels. I generally read through the episodes but I still know what is going on.

Swamp People is about alligator hunting. But as with all of these reality shows, it is the personalities that give the show any semblance of interest.

One of the characters is Liz Cavalier. She turned up in the second season to help King-of-the-Swamp Troy Landry when his other hired hand had something else to do. Landry's "Choot 'em Elitabeth" became one of those lines that you say around the house sometimes, just for a laugh.

In Season 3, Liz went out on her own, and she's the Queen of the Swamp. Last year she took on a young woman named Kristi as a helper, but this year when the show started, Liz, who is in her early 40s, was working with her daughter, Jessica. This was because Kristi was busy taking care of her farm and daughter Jessica didn't want her mom out on the bayou alone.

The reason Mom shouldn't have been alone? Liz had just had her gallbladder removed but she was out there wrestling 800-pound alligators even though the doctor said she shouldn't do that.

Since I just had my gallbladder removed, I know how Liz might have been feeling, and I simply have to salute a woman who could have her belly cut open and then go out and wrestle an alligator.

I'm much too wimpy to do something like that. Heck, I haven't even picked up a full bag of groceries yet.

There were a few times on the show when Liz grabbed her side and howled in pain. I have to wonder if she ripped a stitch or two. I mean, damn, woman.

So anyway, 50-year-old me is no alligator queen. I ain't even a queen of the grocery.

How I'm Doin'

So 17 days ago I had my gallbladder removed. How you doin', woman? How are you feeling this far out?

My gallbladder surgery involved four incisions: one in the middle of my chest, two in the side, and one in my belly button.

This is a picture of myself that I took last week.

Last week

Don't I look terrible?

I was pretty sick the week before my surgery and I have dropped some weight. The weight loss, while welcome, makes me look a little worse for the wear. The lack of makeup doesn't help any either. Also, I'm still fat even though I have lost a few pounds. There ain't no gettin' around that. I yam what I yam. I have been good about my diet since I came home from the hospital, though, and have continued to shed a few more pounds. I hope that continues.

Today

Today my belly looks worse than it did when I took that picture last week, because I've had an allergic reaction to my sutures or something, and there is an itchy rash all over my stomach.  The rash was just starting when I had my post-op visit last week, and has only grown worse. If it isn't better by Thursday, I guess I will need to return to the doctor.


I had some minor complications with my surgery. I've had a number of previous operations and I had a lot of scar tissue. The end result is a pretty long incision at my belly button, longer than normal, because the surgeon had to cut around the scar tissue.

I've also had some difficulty with my asthma during these two weeks. That began in the hospital after surgery and has continued sporadically. I am hoping it will calm down soon.

However, the pain in my belly is lessening every day, and that is good news. If I can get the rash to go away, I will be feeling much better.

Today I did a little writing and on Wednesday I plan to resume teaching at the community college. I have two more class sessions that I need to finish up. Hopefully a lot of makeup will make me look a little better.

This is how I am. I hope you're all doing well.

Slow Down, You Move Too Fast

Sitting around apparently was what I needed. A little rest and relaxation seems to have helped a whole pile of pains I was experiencing prior to surgery.

It makes me wonder if we aren't all hurrying a bit too much. Maybe we need to slow down, take some time off, break away from the bytes and read a book or take a long walk in the woods.

I don't know if my health issues will return when I am back up to full speed, but I have enjoyed this past week of no worries and no rushing. I've had nothing to do but heal from my surgery. That this enforced rest has helped other parts of me has been a surprise and a big bonus.

I think in the United States we put ourselves under far too much stress. It is not healthy. Stress is actually the #1 health problem in this country.

Stress contributes to hypertension, strokes, heart attacks, diabetes, ulcers, neck or low back pain and other “Diseases of Civilization.”

Did you know there are four kinds of stress?

Acute Stress: The familiar fight or flight syndrome, and what we tend to think of when we think of "stress."  The body prepares to defend itself.  It takes about 90 minutes for the metabolism to return to normal when the response is over.

Chronic Stress: The cost of daily living: bills, kids, jobs…This is the stress we tend to ignore or push down.  Left uncontrolled this stress affects your health- your body and your immune system.

Eustress: Stress in daily life that has positive connotations, such as marriage, promotion, having a baby, winning money, making new friends, graduations . . .

Distress: Stress in daily life that has negative connotations, such as divorce, punishment, injury, negative feelings, financial problems, work difficulties, etc.

We need to just feel groovy and forget about it!

A Comedy of Errors

I am pretty sure that calling an operation and hospital recovery a "comedy of errors" is not the type of thing you want to hear when discussing such serious happenings.

However, sometimes after it is all over, you have to laugh.

This all started about 10 days ago. I began having a lot of pain and nausea. On Sunday, June 23, I went to the emergency room. I started out at the urgent care in Daleville and they said I needed to go to the ER. So I spent most of Sunday having tests and things run.

An ultrasound determined I had gallstones. Gallstones form in the gallbladder and have something to do with bile from the liver. They can cause lots of problems, ranging from pain to blocking bile ducts. When they block ducts apparently that causes even more problems, some quite serious.

I spent last week in a lot of pain and feeling sick. I could not eat much - everything made my tummy hurt. I dropped about 8 pounds in four days.

I saw my regular physician as instructed and she made me an appointment to see a surgeon. The surgeon saw me Thursday. He looked at me and said, "I have some time tomorrow afternoon, why don't we just get this over with?" So he scheduled the surgery for Friday.

We spent several hours Thursday having blood drawn and answering a zillion questions about my health. This was the pre-registration process for surgery.

We arrived at the hospital at 11:25 a.m.; my surgery was scheduled for 1:15 p.m.

One of the nurses in the pre-op was named Mike. He was a nice guy but he insisted on putting in the IV under my wrist, which was painful. It also meant I had to hold my hand out completely straight or things would kink. He asked the anesthesiologist to put in a different IV while I was unconscious.

I met the anesthesiologist, who seemed nice but in a hurry. Then I met an operating nurse and the surgeon came in. They wheeled me off to surgery, and into the operating room. I could see the big lights, and they introduced me to two other people in the room. The last thing I remember was being told to slide over onto the operating table.

I woke up in recovery. Someone was with me, saying unintelligible things. I remember being nearly unconscious and saying "pain pain pain" or "water water water" at random times. After the nurse determined I was awake, he left me alone a lot (This was a different guy, not the pre-op nurse). I know at one point I was laying there going "hello is anyone there can you hear me I need some water I am in pain hello hello hello." I remember getting a little irritated because no one was helping me.

The doctor came in and told me things went well. He asked if I had seen my husband and I said no.

Later they took me to a room, and James met me up there. There we discovered that my surgeon had not left any post-operative medications for me. This meant the nurses could not give me any pain killers.

One woman stood there for 20 minutes going over my entire health history again (this would be the third time). I am not sure the point of this - do their computers not talk to each other? At any rate, I think in between every question she asked I said, "I need something for pain," but they couldn't give me anything. I just kept on answering questions.

I don't know how long I laid there hurting before they finally got that all sorted out. However, there was nothing allowed for nausea. So in the middle of the night when I started to feel sick, once again there was nothing they could give me.

In the meantime, we discovered that they had not brought up my clothes and shoes, which were supposed to have come with me from the pre-op room. We also discovered that the air conditioning system was not working in the room, and it was hot and stuffy.

They brought us a fan (which the hospital CHARGED us for and we brought home).

My husband was fit to be tied by this time. Most upsetting was the lack of pain medication. He was ready to punch someone in the nose, I think.

Eventually they found my clothes. My husband was afraid to leave me after all of this, so he stayed until about 1:30 a.m. when I insisted he go home and get some sleep. I grew nauseated around 4 a.m. and it was two hours later before they finally gave me something to help that. In the meantime they kept trying to feed me orange-flavored things even though I am allergic to citrus and kept asking for something else. I don't know if there is real citrus flavoring in their jello but it wasn't worth the risk.

After that bumpy start it was a relief to be discharged about lunch time. However, I think they let you go too soon and I would have been better off in the hospital for another day. But this is what happens with drive-by surgery as implemented by insurance companies, not by need.

I hope I never need another surgery.

Drive By Surgery

Friday afternoon I had my gallbladder removed.

I was home by 2 p.m. on Saturday.

Still recovering. I am doing about as well as one might expect given a missing body part.

Will write more later!

Fancy Footwear

After months of hobbling around trying to heal a painful right foot, I finally went to the orthopedist Monday.

He put me back in a boot.

I was in a surgical shoe for a similar issue in late 2011. I still have the surgical shoe and since it is less bulky than this monstrous thing that goes all the way to my knee I suspect I will be wearing it some, as well. Particularly when I go out if I feel I need to.

The diagnosis was a multiple one of arthritis, plantar fasciitis, and tendonitis. I have the three itises, I guess. I have been limping around for a while.

I've had trouble with my feet since 2007, off and on. Plantar fasciitis is a bear and it eases up but apparently is never cured. The first time it flared up it was mostly in the left foot; this time it's the other side.

The doctor also recommended I wear a night splint, which is essentially the same thing you see above except you wear it at night and you aren't supposed to walk in it much. I have tried one in the past and not found it especially helpful; also, it interfered greatly with my sleep and getting your sleep is as important as anything else. So I don't know that I will follow that recommendation but I will look for the night splint I used last time.

It's Ok in the End

The exam was on the 17th, and I got the call-back about a problem on the 18th.  I had not anticipated that.

I tried to tell myself it was nothing to worry about. But I had a long wait - 13 days. I could not get in for retesting until yesterday.

Most of the time I tried not to think about it. Maybe it was nothing serious. A shadow. But try as I might I could not shake the worry.

My home is full of clocks, because I love clocks. My office resonates with a steady  tick, tick, tick. So sometimes when I wasn't expecting it, the noise turned into a chant of sick, sick, sick - which I quickly turned into no, no, no, when I realized what I was hearing.

I spent a little time thinking about my life. Had it all been a waste, these last 49 soon-to-be 50 years? And how would I react if I received the most devastating of news? I remembered my mother on the day she learned she would die, and her subsequent reactions - not all of them good. Everyone takes it in in her own way, I suppose.

I wondered who, if anyone, would stand by me. Would someone be with me at the end? Would someone hold my hand when I needed it, or would I cry alone in the night? Would I be strong enough to dispose of the things I cherish - my journals, my books, my photos, my personal property - or would I have to leave it for some unknown someone to dig through someday?

So many coulda, shoulda, woulda's - too many, really. Too many to count, to pass on, to act on. I thought about how I would like to live another 30 years - and is that too much to ask?

A line from Melissa Etheridge's song Come to My Window kept running through my brain: Nothing fills the blackness that has seeped into my chest. I remember reading an interview where she wondered if, when she was diagnosed with breast cancer, had she called it to her by singing that song. I wondered if I had called it to me, somehow, maybe with bad poetry. I didn't think so, but you never know.

My time filled with things to keep me preoccupied - a little writing, a little reading, cleaning the house, my physical therapy, unnecessary trips to Kroger. More video game hours than normal, because that's a time-sucker if there ever was one. I thought maybe I should start putting my life in order, but I did not. I listened to the clocks instead, hearing them grow louder, tick, tick, tick.

I made no bargains with God. My thought was that I already had so many things wrong with me - enough to fill a Thursday 13 of its own, it's such a long list - that maybe one more wouldn't matter. But maybe one more would break me completely. Or maybe I had met my quota of aches and pains, and the universe would skip over me this once. I think I yearned for the last one, a reprieve.

Bad news has followed me around for years. I've been stoic each time I've heard the doctors make their pronouncements: you have asthma, you have endometriosis, you need surgery, you may die. This time, with my 50th birthday just six weeks away, and with my body aging and my most recent disease diagnosis literally and figuratively riding hard on my back, I felt the expectation of this new test failure in my gut. It was like the second-hand of the clock constantly pricking me, quietly determined to split me open. Sick, sick, sick.

My husband listened to me wonder what would happen. How would he cope? He dismissed my concerns. "You will be all right," he said. Time and again. Convincing himself as much as me.

Monday was especially bad. I was afraid and too tough to tell anyone how scared I was. I moved through the day as if I were buried in sand, already at the bottom of the hourglass. But I woke yesterday morning full of energy, raring to go and eager for the hours to pass. To get it over with. To know.

And when the nurse came in before the tests began anew and said the doctor thought it was a cyst, not cancer, I was relieved, then angry. How dare they call me like that? For all they had said was that the mammogram had a problem, there was a spot, something was wrong, I needed to do it again. They used the word "density" and I conjured up dire, despair, and darkness.

The new tests confirmed the doctor's suspicion. Nothing to worry about, this time. I could move along, go ahead with my life. But it is tough to get back to the routine now. I think about women who are not so lucky, who have to face every day with a brave, strong heart. I remember my mother and how cancer took her, and how hard she fought, failing, in the end.

There really are no words. There is not a sound I could make that would bring comfort and hope. There is only the silence, the ticking of that clock. That interminable, never-ending noise.




**I understand that great strides have been made in the care and treatment of breast cancer. It is imperative that all women keep up with their self-exams and scheduled mammograms. These days the prognosis is good even if the news is not. Do not be afraid. Easy for me to say, I know.**

Professional Therapies

Back in November, my primary care doctor sent me to a specialist to see about a problem with my back. The specialist sent me to physical therapy, the first step in a long process necessary to help me with my health care issue.

Unfortunately I've had a number of physical problems besides my back show themselves in the last several months. At the moment my physical therapist is juggling orders for me from three different doctors, all of whom want various body parts strengthened or functioning better. It is a lot of work and requires a lot of attention from my physical therapist.

I am visiting Professional Therapies in Daleville. Occasionally I like to applaud people who are doing good things in the area, and I have to tell you, the ladies at this health care facility are excellent. They are there to help you, not just take your money and send you on your way. The personal care is exceptional.

From Lisa at the front desk to Audrey, my terrific physical therapist who takes care of me, I have had nothing but wonderful attention and great communication.

This is a company that lives up to its claims on its website. They really do care about people and want to make lives better. I have seen this not only with myself, but also with others as I have watched the various therapists while I am there. They display infinite patience while dealing with cranky people who are in pain and are not at their best.

I have been visiting long enough now that even therapists I have not worked with know my name. It is not unusual for me to be doing some type of activity in the common room with the equipment and hear one of them call out,"That's great, Anita!" or "Good job!" I am a champ at some of the balance exercises; others, not so much. But that's okay because I am trying.

My progress has been steadily incremental, if not fantastic, and those small improvements have been applauded. When I am unhappy because it seems to be taking forever to improve, Audrey reminds me of the small amount of weight that I could lift when I first came in. Now I am lifting almost 10 times that. I have been very grateful for her positive attitude and those reminders.

I cannot imagine how difficult the job of physical therapist is. Messing with people's bodies, dealing with folks who are in pain - it can't be pleasant. Plus you have to keep up conversation all day and there is only so many ways to discuss the weather. They have herculean tasks before them with every patient, and each physical therapist works her way through it, one labor at a time. I am amazed every time I go in for my work out.

These ladies work with people of all ages, from tiny children to white-haired old ladies who are scared of falling. Not once in all the time I have been visiting have I heard them raise their voices, lose their temper, or be unkind.

I wanted to take a moment to laud these unsung heroes of the health care system. If all health care was like this - wellness assistance provided by people who really do want to see you improve - I think we would all be much better off.

Weighting the Watch, Watching the Weight

Yesterday I signed up for Weight Watchers. Again.

This is my second-go round with WW. The first time was in 2011, and I lost weight on the program, but I have gained it all back (and then some).

My weight was under control, more or less, until I started trying to have a child. When I underwent endometriosis and fertility treatments, my hormones went bonkers. One of the drugs I was on packed pounds on me - I remember I gained 30 pounds in six weeks on one of the medications. The doctors said "Oh no, it's not the medicine," but years later a study indicated that the particular drug could nearly double a woman's weight. At the time I was taking massive doses of this drug, too - way more than they recommend now. It was a new thing at the time and I was, more or less, a guinea pig. They have the drug under better control now, and I suspect it is also not a first-line drug of choice these days.

I was not raised up eating right. My mother worked a full-time job and after a certain point in time, we fed ourselves. For a long time I thought a bolgna, ketchup, and mayonnaise sandwich on white bread met all four food groups. Swanson's frozen dinners were a girl's best friend.

Today I know better but I still struggle to put the knowledge into action. I have trouble with the trans fat thing, and sweets. I am a certified chocoholic, and the best thing I can do is just leave the stuff alone completely. It is easier when other things in my life are going well.

It would also help if I could actually cook. Oh, I can roast things or whatever, but I do not make complicated, tasty dishes. Plain Jane, that's me. I don't like to read recipes and I don't like playing with my food. Maybe I need cooking lessons.

My struggles with weight have been going on now for 25 years - half of my life. The first half of my life I was in good shape, but I have not done so well with the last half. I am a sedentary person - I prefer reading to running a marathon - and I have other health issues that must be addressed, too. It is tough to walk when your foot is swollen, and it is hard to lift weights when your shoulder and back hurts.

Anyway, I am writing this as a shout-out to anyone else who might be doing the weight thing. Perhaps we could hold hands and jump together? I will try not to write about this struggle too much as I don't want to bore anyone, but I make no promises. This might be my last refuge.

All support welcome.

Happy Monday.

On Being Happy

This is from an article I read yesterday:

While the United States has one of the world’s largest per capita GDPs, it trails most other wealthy countries and some poorer ones in many ways. A few examples:

• Americans are more likely to report experiencing stress than are people of 144 other nations. Rich and poor Americans are more likely to be anxious or worried than people in 88 other nations. The United States ranks 11th in “life satisfaction” according to the Gallup-Healthways poll, but well below Denmark, Finland, Norway, and the Netherlands.
• Americans consume nearly two-thirds of the world’s antidepressants.
• More than a third of Americans over 45 report being chronically lonely, up from 20 percent in 2000.
• U.S. life expectancy is 50th in the world according to the CIA World Factbook, shorter than in any other rich country, despite the fact that Americans spend twice as much on health care per capita than other countries do.
• Rates of poverty and child poverty in the US are the highest among wealthy countries, and more than double the average in Europe.

Yet sadly, the American economic model is becoming more dominant, even in Europe. We are sacrificing our health, happiness, social connection, leisure time, and the environment in the blind pursuit of growth. We can’t go on like this.
From - The Happiness Initiative: The Serious Business of WellBeing

When I was reading those statistics I was reminded of Will McAvoy's opening speech in the fictional HBO show The Newsroom, where he points out that the USA is not the greatest nation in the world. "We lead the world in only three categories: number of incarcerated citizens per capita, number of adults who believe angels are real, and in defense spending, where we spend more than the next 26 countries combined," McAvoy says.

I guess if you want to be a nation of poor, miserable, lonely drug addicts with prison records who die early deaths, we're doing just fine.

I would like to think we're better than that, but obviously we are not.

As I write this, we are into our first full day of something called a "sequester," which entails $85 billion in cuts to federal spending. The cuts are across the board and who knows what the fall out will be. Will grandmas who depend on Meals on Wheels end up with no lunch? Will children in Head Start fall behind? Will our shores go unprotected because we're still outspending the world in defense efforts?

I don't know. I am fairly sure that these cuts will only add to the happiness quotient of certain rich white men and others who call themselves "teapartiers" because they don't know any better. And I think that last category of folks will ultimately end up miserable because of it but likely will never know what hit them. They'll be too busy blaming something else.

But back to being happy. What is happy, anyway? This article says this about happiness:

According to psychology research, . . . about 50 percent of how happy you are depends on genetics, 10 percent on environmental factors (such as the state where you live!), and the remaining 40 percent on things that you can control day-to-day. -- Revealed, How Happy Your State Is
 

Okay, that is how happiness happens, I suppose. According to this article, my state, Virginia, has a 67 rating in the happiness scale, just a little above average. Hawaii is number one and West Virginia, right next door, is dead last. As best I can tell, the results are from a couple of years ago. I hear a lot of grumbling about the state government these days; maybe we're not so happy here anymore.

Many people confuse pleasure with happiness. I take great pleasure in eating fine chocolate, but is that happiness? Maybe momentarily. But happiness, I think, is something long-lasting, that is there nestled in a corner even during times of great grief. It is that little grain of happiness that allows people to endure and go on, perhaps.

According to this article, you need three things to be happy:

• self esteem
• a life purpose
• reliable "tools" (attitudes, beliefs, etc.) that work to bring you joy.

I am not a happy person. I am the first to admit it. Life has been tough on me, and frankly I have had way more than my fair share of crap and BS over the years. On occasion, I have told people bits and pieces of my life and made them cry, so I don't talk about it in public. I certainly don't write about it in my blog where the world can see it. I don't like to make people sad.

I will say that my self esteem is in the toilet and generally always has been. Part of that comes from being born a girl, a misfortune of nature that I could not possibly overcome. It is the biggest reason I find feminism and women's liberation so heady, because I have known from birth that others thought me inferior simply because I didn't have a penis. Finding out that that inferiority is unwarranted is a wonderful thing.

However, many folks seem hell-bent on proving to me that I am inferior, a nothing, and to ensure I know my place. I find that continues to happen today, often to my great surprise. Sometimes it comes at me from completely unexpected quarters - there I am minding my own business and boom! someone lets me know that I should not be strong-willed, express an opinion, attempt to do my work, try to better myself or my world, or what-have-you. I guess this is because I think differently than most, I am analytical, and, I have finally learned, I really am a fairly smart girl and few people like smart women. It is not because I am wrong, because frequently I am right or proven right later (if I'm wrong then by all means correct me, says the doormat). Sometimes it feels as if the entire world has gathered at my doorstep explicitly to rain anvils down on my head and beat me to the ground until I'm a sobbing, bloody pulp.

Frequently, they succeed.

However, I always get back up again. I may not be a happy person, but I am a resilient one. I am growing older, though, and I don't bounce back quite as well as I once did. I also find that with each knock-out punch, however brief, I become more cynical. One of these days I might even wake up from one and find I have become mean due to brain damage.

I have had a tough time lately. I will be turning 50 in a few months, and I am not taking it well. My health is in decline despite efforts to do better. I've been diagnosed with a number of problems that are chronic and that will require attention for however long I have left. My life probably peaked about six years ago and its all downhill from here. My happiness outlook is not very good, to be perfectly honest.

I've even thought about stopping my blog, because I have been unable to keep thinking of happy - or at least neutral - things to write. Maybe it is time to move on.

But I do like making others happy, or at least giving them pleasure. I may not be able to do it for myself, but I wonder, can I do it for you?