You’re Going to Put That WHERE?!?


Okay, okay. This is not my spine, but it is the closest photo I could find to what mine looks like.
The verdict after being off for months is that it was never my shoulder to begin with. I was not a hypochondriac. We know this.

So to recap, I had protruding/ bulging discs of the C4-C5 and C5-C6 discs. And no curvature of my cervical spine. And bone spurs. And muscle spasms. The miracle treatment is supposed to be epidural steroid injections. Everyone said these were bad, but I went in with not-so-fond memories of my 17P injections during my pregnancy with Zach. If i got those bad boys in my hips every five days for months on end, and they were supposed to be excruciating, how bad could a cervical epidural steroid injection be? Plus, I had spinal anesthesia with both of my c-sections. No prob, so long as they give me a local first.

So I waited anxiously to get in with the doc, with the idea that, while a course of 3 injections 2 weeks apart is the prescribed therapy, I could very well feel better with as little as one. That was going to be me! I am going back to work next week, damn it!

Well….

A) I was wrong.

And B) I was even more wrong.

Did I mention I was wrong? P17 injections aren’t that unpleasant. They are a walk in the park on a breezy day under the cover of a fucking rainbow, while fairies hum a ditty in your ear.

Epidural steroid injections suck, and I am about to tell you all of the gory details.

The doc, though very nice, pulled me into his office and had a frank discussion about my neck MRI, explaining thoroughly why I had pain in my shoulder, that it was normal for my results. He then said he thought the injections would help, but that it is highly possible that I will still need surgery to fix it.

What?

Excuse me? I thought I was out of the woods there. Then he opened the “informed consent” part of our little talk to say, “Well, Andrea, I have never paralyzed anyone, but it can happen.” What? No! You don’t say that right before I am about to let you stick very large needles into my spine! It’s like me walking in to stick the artery of a patient who has been a hard stick in the past. I don’t brag that I have only missed the artery about 5 times in my career (though true), because then I am sure to miss. So I immediately knocked on the wood of his desk. To which he laughed. Laugh away, pal, but you better be doing it too.

So I go in and lay face first on a table while they maneuver large equipment over me. The imaging part of it. I want them to see where they’re going. I like being able to use my limbs. And he starts. First the local. Stinging, but not bad. Then the big needle. Okay. Uncomfortable. Like spinal anesthesia, it’s a weird thing, and you feel pressure. And so I felt that and though the needle was where it needed to be. I heard him rustling around. I thought he was getting the drug. And then he said, “Okay, almost there.” What? Almost? So I can only assume he  advanced it a little more. This was a little more painful. And then came the gross part. I could fucking hear it. Like tearing through gristle of a steak. Creaks and tearing and grinding sounds. And I exclaimed, “Ewwww! GROSS! I can hear that!!!!!” To which the doc said, “Oh, that was just a ligament I passed the needle through,” as he chuckled. Dude, sooooo not funny. Then more grinding and popping. Keep in mind that my affected side is my right, so they were doing this on my the back of my neck, but right of midline, so it was right under my ear. More tearing. It was the most wicked thing ever. And gross because it was my body. Had it been another patient, it would have been cool. But it seems like he said “Almost there,” followed by more advancing of the needle a gazillion times. Until I felt IT. And by “IT” I mean excruciating pain. Excruciating, horrendous pain. The worst pain I have ever felt in my life. No 17P injections, no high risk pregnancies, no contractions I have ever felt could even come close to that pain. None of it. He could tell, because my legs kicked out involuntarily, and I stopped breathing for a few. All I could do was let out this little squeak. He gave me more anesthetic then, because he’s a fricken angel. And told me we were almost there.

Almost fucking there? Really? After that?  In an instant, I thought about stopping the whole thing right there. Of getting up and walking out immediately. I thought better of it, since there was, at that point, a massive needle inserting in my spine at or near my fucking spinal cord, And then more advancing. And I suddenly knew he had reached the right place. I knew, because I could not help but know, what with the huge jolt of what felt like an electric shock fire from my right shoulder to my right elbow. I couldn’t help it. I yelled out, “What the HELL was that?!?”  To which I got giggles. And “Okay, I’m in the right place if you felt that! Where did you feel it?” Dude, you are messing with my nerves. Literally, not figuratively. You know where I felt it!

And he delivered the medicine. I was able to move. He showed me the images from the fluoroscopy because I told him the medical geek in me had found it hard not to look up and see what he was doing, but my love for not being paralyzed kept my impulses at bay. So he was kind enough to show me, explaining all of the structures that I remember from A&P years ago, but have not used since. And I got to see images of the needle as it passed through muscle, tendons, ligaments. I was released and told to go home immediately and ice it and take it easy, which I heard as, “Go ahead and go with John and the kids and get groceries, eat at B-Dub’s, and type all three of your papers tonight”. Well, because I am me. And I had papers due. And I deserved fucking Spicy Garlic hot wings after that. And, well, the kids have to eat, too.

Sometime within the fifteen minutes in which we were en route to the restaurant, the anesthetic wore off and I turned into a lunatic. Bracing myself with my arm on the dashboard. Completely afraid of John applying the brakes or accelerating too harshly. Afraid of traffic, because if John hit someone or someone hit us, I could not take it at that point. And I started to whimper. Then cry. The all-out sob. Because I was terrified. I could feel the pain setting in. I felt so strange. My chest was hurting. My shoulder. My ears. It wasn’t terrible yet, but I knew the anesthetic was wearing off and it was coming. We hurried and ate. Hurried and got a few groceries. ($98.69–The only time I have ever spent less than $100 in a grocery store ever!) And I got home. And it was bad. So, so bad. I took a pain pill, Percocet and my muscle relaxer, Flexeril–which usually knock me completely out. it did nothing. I felt drugged and high as a kite, but the pain was there and I did not konk out. I even managed to write my papers. In order to do this, I had to put the laptop on a stack of eight textbooks, then prop my arms with pillows because I could not bend my neck at all to look at the screen.And I cannot guarantee that the writing does not read like a crackhead wrote it. Graduate level Business Strategy through the voice of a junkie is probably very entertaining. I cannot wait to see my grades. The only redeeming factor is that I did my research for the papers while I was completely sober and coherent. I’m just hoping I included punctuation at this point.

This morning? Well this morning, it kind of feels…awful. The pain spreads from my ears to my lower back. I cannot turn my head. I cannot move my right arm at all without pain. Before, only certain movements hurt. Sitting up hurts, laying down hurts. The kids are still kids, and John is still at work, which gives me eight whole hours before I can take something. John even drove my car to work because I couldn’t drive if I had to. I am now electively allowing them to destroy the fucking kitchen because I have no power to stop them and so long as they do not get hurt, I couldn’t care less about the mess. Zach’s speech therapist comes this afternoon, and I don’t even care how the house looks. I’ll make Evan vacuum a clean space on the floor, since this is where she sits with Zach anyway. We are going for Crackhouse Chic today. Fine by me. We will definitely reach that goal.

 

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The (Before Grad School) Bucket List

I guess the point behind the bucket list is that is is what one would like to do before they die. Well, I have no intention of going anywhere, but I am starting a rather “ambitious” first semester of grad school. (My advisor’s words, not mine.) I have this feeling that between working, school, and family, there will be precious little time. But the thing is, I love Cincinnati. It is my hometown. My memories of my childhood are here. But there are some things I have never done or have not done in years that are soooo Cincinnati. I want to take John and the boys to do some things and experience the city in ways they haven’t  to date.

1. Findlay Market

What can I say about Findlay? Huge farmer’s market meets international market meets a shopping center full of ecclectic and non-traditional shops. All local merchants. You can grab a gourmet lunch at a little cafe, shop for organic produce, and just about anything else from what I hear. Street performers wander the crowds, from what I hear. I wouldn’t know first-hand. I’ve never been. There, I admitted it. I am as Cincinnatian as they come and I have not been to Findlay. I want to fix that. Here lately, I am becoming more aware of what we put into our bodies, and I know that this would be the place. Finances have stopped me, as I know I will spend a ton. But I plan to fix this all sometime before the summer ends.

2. Coney Island
Yeah, in Cincinnati. We have one, too, though I am sure it is not the same as the origiinal. I am not big on amusement parks, but Coney is small enough and nostagic enough to feel more like a fair, from what I hear. Never been here, either. I want to take the boys. Zach needs his first real taste of a funnel cake, and Evan would have a blast on the rides.

3. Cincinnati Zoo and Botanical Garden

Of course we’ve been to the zoo a gazillion times. Evan has with us, with visiting grandparents, on school trips. Zach? Well, Zach has never been. And we certainly haven’t been this year. I’ve been off of work. It’s been…weird. But the boys are due for a zoo trip, and we have a great zoo here. I would love to be able to do this before my nose hits he grindstone.

4. The Precinct

I am sure there are people in this city who can afford to dine here everyday, but we are not those people. And this is most certainly not the place to take children. But one night, I would love to have a date night with my husband and have dinner here. Never been, but I hear the steak melts in your mouth, and we …we are some carnivores.

5. Sunlite PoolSunlite pool, well, is technically a part of Coney Island, but it is an all-day adventure, also. I want to be able to take the kids. I haven’t been able to go swimming at all this summer. John works during the day and I have one good arm right now. My hope is that, sometime before summer ends, we can do this. I know Zach will love the water, and who could resist that cool, crisp blueness?

6., 7., 8. The Cincinnati Museum Center

Nothing is more Cincinnati than the Museum Center in Union Terminal. The building is totally art deco and has still has the cool retro feel of the 1930’s train station it once was. And it’s profile is just a part of the Cincinnati landscape.

Inside the terminal, there are several museums. The Children’s Museum houses all sorts of interactive activities for the little one, and for once, there is no need to worry that my boys will destroy something.


Aside from this, there is the Museum of Natural History and Science, which is about like any other. There is also an Omn imax and many other special exhibits, so we could make a day of it rather inexpensively, and I am all about that these days.

So there is what I want to do with the little bit that will be left of our summer after I finish recovering from the herniated discs and am able to get on with my life. The little time I have before hell unleashes on my schedule and I have no time to breathe. Realistically, if I could get the boys to cooperate for just a few of those outings, I would be tickled pink. The difficulty in having children so far apart in age is that what would interest one will be of no interest to the other. It is difficult to find things to do that are fun for all.

Mommy is Losing Her S###

[Disclaimer: I say what I damned well please on here. I say things I would never say to my children because I don’t want to scar them. And the oldest knows Mommy has a blog, but he doesn’t read it. Nor would I do any of the stuff I may say in this post. Please do not call social services on me. aND THIS POST INVOLVES THE WORD “FUCK” AN AWFUL FUCKING LOT. Consider yourself warned. Thanks.]

My children are amazing. They really are. Pretty. Cute. Smart. Funny. Creative. I would dare say that they shit rainbows and butterflies.

I am going to kill these little fuckers.

How can someone so short create such a path of destruction?

John used to do this. The kids were his gig. I loved them and ensured they got immunizations and dental checkups, that there was an array of nutritious food for them. I played with them, cuddled, loved them. And I worked. And did the school thing.

Well the tables turned. Since I have been off of work for the shoulder thing, I have been, basically, a stay-at-home mom. Oh holy shit. These kids are everywhere. Do you have any idea what my days have consisted of for the past 6 weeks?? Do you?

Well, let’s see. At any given point, Zachary is prone to empty the contents of the refrigerator into the kitchen floor. What he is looking for, I have no idea. We bought an appliance lock. He broke it. We bought a different style of lock, and he figured out how to open it. So our newest solution? We cover the entire thing with clear packing tape, and running out of that tape is a federal crisis in this house. About a gazillion times a day, Evan or I will sprint to the fridge to get Zach out of it.

And the baby gate…Oh holy shit. We have replaced it 5 times in 3 months. My house has an awkward arrangement, so it isn’t easy to block stuff off. The bathroom and basement door are right across from each other, so we block the hallway with a baby gate and Zach’s toybox is in our living room. Forget Shabby Chic. We are Toddler Posh. It’s a hot look, and if you have any doubts about that, I challenge you to spread some Duplo Legos, wooden blocks, puzzle pieces, and five tthousand different versions of Lightening McQueen all over your living room floor and see for yourself. My living room is a perpetual dump. But back to the baby gate. I can’t block the kitchen entrance, so we block the hall and let Zach have his run. Until yesterday. That is when that little shit looked me right in the eyes, smiled, and tore down the baby gate in one fell swoop. So just like we dash to the fridge, we are dashing to keep him from plummetting down the basement steps or meeting sudden death through drowning in the damned toilet.

Evan is supposed to be the helper while I am…challenged with one good arm. He is more like the ringleader. “Mom, Zach wants…..” Fill in the blank. Strawberries are the newest. But usually it is some variation of junk food that will get mashed into carpet, which results in the need to use the vacuum, which is too heavy for me to lift and use with one arm. (Fuck you, Kirby Salesman.) Or he wants to watch a movie, at which point Evan will crank the volume up on the tv, insisting it is cool like that because it is like a theater.

Nothing is sacred. Nothing. Over my desk is a huge dry erase board, and I use it to write notes. The latest is the list of words. Every week, when Zach’s speech therapist comes, we recount the new words he has said since her last visit. Now that he is trying to talk more and more, we write the words on the board. So Evan will try to get him to say new words so he has an excuse to get the dry erase markers and climb on my desk. I love seeing an 80-lb. clutzy kid standing on my desk an inch from the laptop I rely upon for school. Love it.

And the damned phone. Oh my God, the phone. My cell, that is. Everytime I turn my back–to answer the land line, write an email, pee, grab a cup of coffee—I turn around and Evan is on my fucking cell phone. Running the battery dead, downloading any and every free game he can find. Watching the same God-forsaken video on Youtube.You need a little slice of this to understand, so turn up your speakers and press play for this little slice of heaven.

Yeah. Full blast. All motherfucking day. No, I’m not kidding. Zach tries to sing along, which was funny the first few times. It isn’t anymore. I keep reminding myself that Evan has an unofficial Autism Spectrum Disorder. He’s off a little. This is enugh to keep me from completely killing him, but it is not enough to keep me from wanting to curl up in the bathtub with a fifth of Grey Fucking Goose. Oh wait. I’m poor now because I am off of work. Make that Smirnoff.

And Cars. Fuck you, Disney/ Pixar. I hate Lightening McQueen. Lightening McQueen infiltrates everything we do. Everything. Zach will not take a nap without a Lightening McQueen cllutched in each chubby little fist. And the Disney people, being as smart as they are, made several different forms of him. The one from Cars 2. The one who drove throough the fence in the beginning of the first movie. Dirt Track McQueen. Dinoco McQueen….Bling McQueen–he has fancy rims on him. No, I’m not kidding. Zach has all of the ones he has received, plus he has inherited all of them that Evan doesn’t have use for. And Evan had every single one they made at one point. Lightening is in the couch cushions, under the crib, on the entertainment center, in the car. Yesterday, I found one in the fucking dishwasher.

Everytime the phone rings, my children become opportunistic little boogers. Just now, my doctor’s office called to schedule my epidural steroid injections I have been waiting all week to scedule. The call took 2 minutes and while I was on the phone, Evan hurried and thrust 2 frozen pizzas in the microwave. Now I know what you’re thinking. They’re starving. Poor kids. No they are not. Evan’s medicine has weird appetite side effects, so he literally never feels full. If I let him eat whenever he wanted, he would weigh 800 pounds and we would never have groceries in this house. But the point is, 2 minutes. Mom cannot have 2 fucking minutes to answer the phone. And the phone rings more than once a day, especially since I am off of work. There are calls to and from insurance, to and from work, to and from doctors’ offices. One of these times, I am going to hang up and discover he decided to roast a fucking turkey.

So that is my day. If I need to do anything at all, I have to just let them run. If I have a paper due. If I have to visit the bathroom. Showering? Somehow that always waits until John gets home. I am a skanky bitch until 5 PM.  I cannot afford the luxury. And I know some of you moms will use this to explain that this is what you do all day everyday. Well, have a fucking cookie. I bet your kids are normal. I am telling you there is something wrong in this house. No sane human could endure this shit. Right now? Right now, Evan is in the recliner rocking back and forth and making it tip, laughing and doing it all over again, while Zachary sits and rubs the tread of the treadmill. Not fucking normal. Not even close.

So I live for naptime. Zach is quiet for somewhere between one to two hours and I let Evan play on the computer while Zach is asleep. He can put in his ear buds and listen to “Retarded Running Horse” on a continuous fucking loop the entire time. And I sneak out to the porch, close the door, and chain smoke the hell out of Marlboro Ultralight 100’s with the shaking hands of a heroin addict going through DT’s. (Don’t judge me. If I didn’t do ths, I would cut a bitch, I swear. Besides, it isn’t around the kids, is once a day, and nobody can say I am uneducated about what I am doing.)

At some point, John comes home. He futzes with his shower. He masturbates over the God-Forsaken Harley—putting it away, cleaning it (OH MY GOD IS THAT ROAD DUST ON THE FUCKING HARLEY? GET IT OFF STAT!!!!!!). We eat dinner. The kids have to be bathed, and I cry because I have a shit ton of stuff to do that cannot be done until he stops jacking off and handles the kids so I can fucking do it already.

I AM GOING INSANE. Fuck this shit.

 

The Admissions Mistake

This is such a strange time for me. Well, “surreal” would be a good word.

I am wrapping up my undergraduate education. I received my last shipment of textbooks from school this week, considering I tripled my classes again. You may recall that I tripled last session with the plan of doing it again this session, all to finish in time to start grad school. The idea of making me wait was to ensure the course load wasn’t too much for me. It wasn’t and I got straight A’s again. If I pull it off this session as well, I will honestly be able to say that I have not gotten a B at all. And I will have completed my BBA that way.

Hmm. Completing my BBA. Let me talk to you about my higher education. I was the first one to go to college straight from high school in my family. I was supposed to do great things. I had been in the gifted classes all through my education, and was contemplating pre-medicine as my major. The problem was that I played classical flute for years and years, and I was good. My second choice was a music major. My mother helped me make the decision, stating that medical school was for the wealthy. Full financial aid was not a likelihood back then as much as it is now. So I went with music. And where I was good, that was the biggest blow to my ego. Because they were all good. I was one of the worst of the really good ones, and even I knew that to create a career in music, you really have to be the best. That was immaterial, because I didn’t finish. Mom was at home, dying. I was treated for a horrible deep depression. The classes that were to be so easy ended up being the greatest challenge just to show up. When mom finally died, it was just too much and I dropped out.This gave my brothers and sisters in my dysfunctional family even more reason to gloat: Andi, the smart one, couldn’t cut it.

Years later, John talked me into respiratory school. I needed a job that would pay what we needed. Suddenly, I was in the medical environment that I was fascinated with as a teen. And when it came to the advanced chemistries and physics, I still had it. I took to it like peanut butter to jelly. Maybe I had made a mistake listening to my mom from the beginning. Maybe medicine is where I belonged all along. So I took as many courses as I could, finished the respiratory degree–it’s just an associate degree–with twice the number of credits I needed to graduate, all because I knew that I wanted to go further. But life and bills got in the way, and my plans to immediately finish a premed degree fell through with the obstacles I encountered. It took several years before I got to the point where I could enroll. And I did. I was chugging along as a premed/ molecular biology major, prepping for my MCAT and working on med school applications when I got pregnant with Zach and bedrest happened.

So after all of this education I have had, I still do not have a bachelor’s degree. I am one educated bitch, in everything from music to the sciences to business, but no baccalaureate degree. That is all changing in about 6 weeks. It seems so strange to be getting a business degree, though. I never dreamed that this is where my life would take me. I would have never thought I would have an aptitude for this field. Honestly, I never thought I would love it. And I honestly thought I would never finish anything higher than my respiratory degree. For some reason, everything I tried has fallen through, and I thought someone was trying to tell me something. Of course this disbelief is compounded by the fact that I will not be donning a cap and gown. Since I completed it in an online program, graduation is across the country at the actual school, and I will not be traveling just for that.

Where I should be excited about finishing the degree, I am anxious. Five days after the end of these next classes, I start B-School. And I am seriously questioning my ability. I do really well at the role of big fish in a small pond. The times I have played the role of small fish in a big pond, something has happened to make me choke on the damned pond water. And I suspect that, even though I am going to a smaller, more elite private university, I am going to be the small fish. I’m afraid that I am the admissions mistake. You know what I’m talking about. The one, every year, that they let in by some fluke or flaw in their system of evaluating applicants. The one that really shouldn’t be there. I have so many questions, so many doubts.

Yeah, I produced the resume they loved. I’m the diversity factor. A woman. Coming from healthcare, not a business field. My application was amongst those of investment bankers and area business leaders, or simply new twenty-something college students fresh from the dorms and delaying the inevitable of going to find work by starting grad school immediately. So I can picture them going through the stack and thinking, “Hmmm. Respiratory Therapist? With an undergrad business degree?” Bizarre, yes. Then my transcripts. My 4.0, immaculate transcripts, with perfect grades in anything from music performance to human genetics. Psychology and Cardiopulmonary Anatomy and Physiology. Organic Chemistry and Corporate Fucking Finance. A’s. All of that shit. Well, you can think that this is one area in which you cannot argue. That was my point in sweating my grades so much through all of this. My grades will never limit me. I ensured that. But I have developed my own doubts. What if those grades are from schools that are too shitty to count? I have mastered the art of being a student, but other than Corporate Fucking Finance, none of it has really been a challenge. Well, maybe O.chem was, just because I hated the class, and now it doesn’t even matter that I did it. My point is, what if my GPA isn’t an indicator of my abilities at all, but an indicator of how easy the classes were?

What if I don’t belong there? What if I choke? What if I manage to navigate successfully and then there is no place in this world for a respiratory therapist with an MBA from a nationally ranked program? Then I am left with the most expensive piece of paper in the history of paper-making.

I guess I could have saved you the time you have spent in reading this by saying two simple words: I’m scared.

I don’t want to be the admissions mistake.

The Great Independence Day Cupcake Fail

What to bring to a 4th of July Parade and Picnic when you only have one good arm? Sugar-free chocolate cupcakes. Makes perfect sense. I had visions of this, except with red, white, and blue sprinkles.Image Well, this isn’t what I got. Let me start from the beginning.

First of all, the plan for cupcakes was so ill-conceived that I really should have seen it coming. I am right-handed and my right arm is the one that is totally effed up. Bad idea indicator #1. Still, like the Little Engine That Could, I was convinced I could make it work. I mixed the ingredients into the mixing bowl and tried to stir. Problem is that my left arm is weak and awkward, and had about as much rhythm as Poindexter at a rap concert. Enter the help of John to beat the batter for me . Then I tried to fill the cupcake liners. Instead of neat little filled cups, I ended up with the chocolate batter slopped all over. I just figured no biggie, so long as the actual cupcakes come out ok.

And they did. They really did. I played online while I waited for them to cool, all while verbally confronting Evan over the harrassment I was receiving to “just eat one now”. I resisted.

Time to ice those bad boys.

Shit.

Let me just tell you that I suck at cake/ baked good decorating anyway, even when I am not impaired and trying to do it with my non-dominant hand. What I ended up with was what I imagine Rain Man with advanced Parkinson’s would create. It was horrible. So I scraped off the icing and started with a fresh batch of frosting. This time I took my time, painstakingly putting tiny dabs of icing on at a time so they would at least look edible and not like someone took a big shit in a cupcake liner.

I did okay. They didn’t look like my vision, but fuckers, I am impaired and I tried.

So today, we are getting ready to go. John is wresling with the big one and little one while I am trying to get ready. I was trying to pack up the cupcakes to go when I stepped on a Lego. (Please tell me why there was a Lego on my kitchen floor!) It hurt like hell, all of my tons of woman-ness coming down on that damned thing. Before I knew what was happening, the cupcakes bit it. Hard. A few ended up smooshed against the belly of myy pristine white tee (layered with a cute red tank and denim capris because I am a patriotic bitch, thankyouverymuch) and the rest of the two dozen ended up compleely upside down on my white tile kitchen floor, resulting in a gooey chocolate mess, complete with red, white, and blue sprinkles.

Really? Really???? Yeah.

This is why I do not bake. This is why Evan’s class gets cupcakes from the upscale trendy gourmet bakery on his birthday. This is why “bring a covered dish”, to me, will always mean mac & cheese or some shit. Because I suck at the Mrs. Fields shit.

So Happy Fourth of July. No cupcakes for you!

Depressed

I have been off of work for going on 6 weeks. Asking a workaholic to do that is like asking a crackhead to just stop being a crackhead. My job is a part of who I am. I am the one which volunteers to work sixty or seventy hours a week. And right now, I am completely cut off. I feel like I currently have nothing to contribute to society. I am a sponge. A liability.

First of all, my earnings are cut in half. So we’re broke. So much of my family’s financial well-being is tied to me, and right now I am feeling the pressure. Last week, my damned water was shut off. Thankfully I had the resources to just go and get it turned back on, but it was still embarrassing.

And work. Once again, outta sight equals outta mind there. Noone checks on me. I want to scream at the top of my lungs,”Hey guys, remember me? The one who has worked your Christmases and Thansgivings so you could stay home with your families?!?” I’m also the one who works like a dog willingly so they won’t have to work so hard on short shifts. But it seems like nobody ever remembers that.

I feel completely alone and completely depressed. I don’t like this feeling at all. I need to go back now now now, but I know it will be a few weeks yet. I just hope I can make it.

I Can’t Afford It: The Inevitable Rant About PPACA from the Inside

I don’t usually get all political up in here. It just isn’t my thing. I have read countless comments on Facebook about the Supreme Court’s decision about the Patient Protection and Affordable Care Act. That shit is everywhere. And everyone has an opinion. “Everyone is entitled to healthcare…” Yeah, okay. Great. Kumbaya, and all of that jazz. If you are disadvantaged and need medical coverage, and there is a way for you to get it, I am all for it. We have programs like that in the U.S. We have for decades. Yes, they suck a little more than the insurance one pays for electively. If I am out of food, and I go to a food bank to get food for my family, the items I get, though appreciated, are not of the same quality I would buy if I went to the grocery store and shopped for myself. You take what you can get. I’m sorry to sound so blunt, but it’s true.

I’ve said it before and I am going to say it again: I used to not have insurance. John worked at a job that paid him $8/ hr. and the benefits were almost $700 per month. Evan was a newborn. So I took an eq\ually crappy job as a housekeeper at a hospital where the insurance was about $400/ month. I essentially  worked for the insurance When the income got to be too little, I went to work on a degree that would pay me what we need, both in income and in benefits. And I’m not afraid to give you the straight dope, though it is poor etiquette. I gross over 8 thou a month. I bring home about 4K of that. What???? Why? Well, simple, really. I pay over half of my income on taxes and pesky little necessities like medical, dental, and vision insurance. Right now, that is the lay of the land. It is how the shit falls.

So while I am not too keen on spending even more of my very hard-earned money to support those who did not have the wherewithal to go out and do what I did–find a beter job, better benefits—I simply cannot afford it. I am not living high on the hog. We have one car. My husband rides his motorcycle in good weather to save on gas. We try to limit our dining out these days. I clip coupons. We live in a house that is way below our means because it is cheap despite being in a nice, white-collar neighborhood. And though I am off for my neck and shoulder right now, I work every God-forsaken hour my employer will allow me to work in order to make more, to pay more in taxes…you get the drift. I cannot afford more of my tax dollars to go to support your healthcare. I will take care of you when you are ill. I will risk contracting any infectious disease you are carrying because someone has to. But I am not willing to sacrifice the well-being of my children to pay for you and yours. I’m sorry.

And there are other misgivings I have about PPACA. This part is coming from a healthcare professional who works in the trenches, from someone who is wrapping up a degree in business \with a concentration in healthcare management. Hospitals rely on reimbursement. They do. The naional average for Medicare and Medicaid reimbursement revenue is around 60% of hospital revenue. The hospital I work for receives about 80% of their revenue from Medicare and Medicaid. That’s a big ol’ piece of the pie. The pie that determines the amount they can do for their community, the services they provide to their patients. And guess what! For added fun, those coffers are getting pretty shallow. Hospitals are fighting harder for less dollars. And we can expect more and more of these patients. This would seem like even more reason for the PPACA, right? Nope, and here’s why:
The PPACA also has implications for providers. More stringent guidelines to provide more cost- effective care. Nothing wrong with that. One of the yardsticks with which providers will be measured is their readmission rates. Currently, there are a few diagnoses where hospitals are penalized for excessive readmissions. As a part of the PPACA, four more will be added by 2015. One of these is COPD.

And that is whete the respiratory therapist in me gets all fired up.

COPD. The bain of my existence. My livelihood. But these are the worst patients that CMS can use to penalize hospitals for readmissions. I understand the concept: if we’re doing our job, the patient won’t be readmitted within a certain time frame. The problem is this: while some COPD patients are dream patients, I would say the majority of my patients are non-compliant. They won’t quit smoking while their alveoli fight with each other for every breath. They pick and choose which of their respiratory meds they take and when. (No, inhaled steroids are not going to work if you only take them as needed, and you should not stop taking them just because they don’t work as rescue inhalers.) And toward the end, they could be in and out of the hospital every week. So if hospitals stop getting reimbursed adequately for these admissions, they lose progressively more money as time goes on. That is the same money they use to attract and recruit higher-credentialed staff. The same money they use to provide indigent care. The same money they use to obtain equipment. To maintain equipment.

But my other problem? We all speak of the access to care. Well, if you live in the U.S., you have access to care. If nothing else, you can go to an ER where we have to evaluate you. That is access. What is truly lacking is a way to pay for it.

Is the U.S. healthcare system having trouble? Yep. I don’t blame hospitals or providers. I don’t blame insurance providers. Thete are many pieces of the puzzle, in my humble opinion. Lawsuits. Malpractice insurance. ER abusers ( by this, I mean drug-seekers, etc.). Doctors being forced to practice defensive medicine. (And if you don’t buy that, ask me and I’ll tell you the crackhead story.) Drug patents. And us. Yes, us. We want the latest and best. When a standard x-ray is sufficient, we still want the CT. When a cheap generic drug will work, we want the brand. And doctors are stuck. Patient satisfaction is a reimbursement buzz word, and if they don’t give us what we want, we get upset and don’t stop until we get it. Whatever it is, it may not be the most cost-effective, or even the most effective. We need to leave doctoring to doctors.

So, yes. I am a healthcare professional. I am hopefully a future hospital administrator. And for all of these reasons and more, I am completely against the PPACA. And I will vote accordingly in November.