Where’s the care part?

Here is a little story about healthcare. My mom has good insurance and is healthy. That’s not the problem. But her experience yesterday points up some of the things about healthcare that make you wonder where the “care” part went and how they can be so inefficient.

My mom has chronic back pain. She puts up with it without complaint until she simply cannot take it anymore then she sees a doctor. That is the point she was at a few weeks ago when they wanted to give her an epidural injection. She had had one years ago and had success with it. This time they wanted to give her two separate injections a few weeks apart. They put her under for the procedure and so my husband drove her to the appointments. The first of the series, like the one a few years ago, went smoothly. She woke up feeling good – the best sleep she had had in months. I swear she looked five years younger the next day. All those nights of waking up in pain can really wear a person down.

Yesterday was the second of the two procedures. She and my husband set off for the appointment early, as they requested, to fill out paper work. When she told them she had been in a mere two weeks before, they said it didn’t matter,  she had to fill out all the paperwork again. The paperwork included a note about two narcotic pain medications that she is allergic to. How inefficient is it to fill out the same paperwork again and again! She waits. They call her back. My husband waits and reads all the old magazines in the office. The last appointment took two hours. Two hours go by this time and nothing. Two and half hours go by and people are packing and leaving the office. Still, nothing. I am concerned when I don’t hear from them and call husband every little bit. Nothing. He walks back like he owns the place and finds her. She is asleep. She has been sick from the anesthetic. Her blood pressure spiked. She has broken out into a cold sweat. They have given her medicine for nausea and an IV. She opens her eyes when he talks to her, but is clearly not well.

The nurse fills him in. He asked the nurse to speak to the anesthesiologist. He is informed that it’s a “nurse anesthetist” and that he has gone home. He makes the nurse get him on the phone. After a very heated conversation, my husband learns that at the other two appointments they have given my mother propofol – yes, that propofol, the one that Michael Jackson liked. Now, the “nurse anesthetist” says there is a shortage nationwide of it, so they were trying to limit the use. They gave her a smaller dosage of it and combined it with a narcotic. Husband asked him if there was a shortage of propofol in their office. No. He had no explanation for why he changed the procedure that had worked so well for her previously. Looking at her paperwork, we see where she has written that she is allergic to the two different narcotics. That was never a consideration, that if she was allergic to similar drugs that this one might not be the best choice for her. There was no discussion of a change in procedure. They didn’t ask her about having a different anesthetic. They just did it. Husband stood over the nurse until he saw her write the name of the narcotic in her file and note that she was never to be given it.

Nearly four hours later, they wheel her out and my husband takes her home. I meet them there. She is so weak and sick. I am furious that they have done this to her. We help her get into bed and she sleeps it off. She is fine. She will be fine, but it didn’t have to be this way.

There is something to be learned here. This is a person with good insurance. She is in good health. Those problems, are just part of the puzzle. This story is the part about the care. You can find treatments that work. You can find solutions to your healthcare needs. Yet, it still comes with risks. Never go to the doctor alone. Even for the most minor procedure, it is best to have an advocate. Be vigilant. You have to ask, they will not tell you otherwise. Know what they are giving you. Know what they gave you before and make sure it is the same. If a change needs to be made, make them tell you about it and tell you why. My mom was lucky to have my husband with her. He is a bulldog in these situations. He will not back down. That is how you have to be.

All Politics Are Local

Before we all get too carried away thinking the elections yesterday are a referendum on Obama or the Democratic party, can we take a look at the big picture? When you step back a bit, the picture you get is a little different. You begin to wonder if the body politic is simply schizophrenic.

So the Republicans took the governor’s seats in New Jersey and Virginia. But, 56% in New Jersey and 60% in Virginia said that Obama had nothing to do with their choice of candidate. Obama has approval ratings of 57% in Jersey and 51% in Virginia. So, does it mean gloom for the Democrats? Of course the GOP thinks so. Yet, they had their own loss yesterday in New York’s 23^rd district. The far right made a play for the seat bringing in the fringe. The third party conservative running against the moderate Republican said Glenn Beck was his hero and was endorsed by Sarah Palin. He lost when the Republican withdrew and lent her support to the Democrat. So, is that a referendum on Sarah Palin? Glenn Beck?

We will continue to hear how this election means something for national politics. It doesn’t. Corzine was unpopular with his constituents. His loss is not a big surprise. Virginia? I don’t get how the thesis that McDonnell wrote while at Regent University didn’t seal the deal for Deeds, but if they want to vote for a guy who thinks legalized birth control for unmarried couples is illogical and that women should stay at home… Well, I can’t make much sense out of that.

There were other points of interest from the elections. Maine voters voted against same-sex marriage. On the other hand, Kalamazoo, Michigan voted to add sexual orientation and gender identity as protected classes in an anti-discrimination law and Chapel Hill voted in an openly gay mayor. And while Maine voters seem illiberal on the gay-rights issue, they voted to license medical marijuana shops. Breckenridge, Colorado toped that, though by voting to just legalize pot (of course it is only symbolic as it is still illegal in state law).

It is not all doom and gloom for the Democrats. The GOP had some victories, but the far right demographic had a setback. That is the most hopeful thing that I think came out of the election, that the crazies didn’t win that one. As a whole, the electorate may be a little schizophrenic, but overall the middle of the road will win out. We’re not that crazy!

Where is the line of overreaction?

Ok, so where do I draw the line around the water cooler? When do I unleash my feminist rage and when do I have to just let it go as the joke that I know it was?

I work in a male dominated office and have a good relationship with all my guys. Today, a few of them overheard a female coworker telling me about Oakland Raiders’ coach, Tom Cable, saying that he had only hit is ex-wife with an “open hand”. I was surprised by their joking attitude. They knew, and I knew, that part of it was a goad to get me going. Still, laughing and telling me “well, I never hit my wife, but sometimes she needs a good shaking” seemed to cross that line. They were riffing on a Chris Rock bit where he had a similar punch line (pun intended). Is it funny though? I just stood there, mute and stunned. I couldn’t think of anything to say. Should I joke about giving my husband a black eye? Should I tell them it was offensive? I debated in silence until they moved on.

The more I think about it, the less funny it seems. While I know that they meant nothing by it, it makes me see them in a different light. It disappoints me that they didn’t know that the joke wasn’t funny.

One Year After

I’ve been mulling over the numerous reviews of the first year of the Obama administration. It seems like the year has been amazingly quick. I read the articles and listen to the reports about how nothing has been done, how he hasn’t lived up to his campaign promises and that he is timid. Wait, I thought Fox said all the other news media were fawning sycophants? It doesn’t seem that way to me. The constant review and evaluation – 100 days, 200 days, 365 days – seems to have been taken to a completely different level for Obama. While I try to be objective about it, I find it hard not be a little pissy about it. Anyone that had been paying attention during the campaign would have known he wasn’t the radical liberal that the GOP wanted to paint as. Anyone that has ever paid any attention to the working of Washington would have known that nothing gets done quickly or easily. No one should have been surprised that the Republicans on the hill would fight against anything put forth – lashing out viciously in the death-throws of the radical right movement. No one should have been surprised that they would be obstructionist. Anyone watching would have known that Obama took office during the most serious financial crisis in decades, with two inherited wars and a huge deficit. Throw in a flu pandemic for the cherry on top.

But, I’m being told that I should be disappointed that the world is not fixed yet?!

I feel the coverage is a distraction. Things are happening. Things are in motion. You can’t call the game after the first quarter. It took the Bush administration eight years to break the world. It might take a little longer than a year to put it back together.

And, what about our responsibility? What have you done this last year to make the world a better place?

…and it really only gets better after they’re 30

I came to work this morning tuning out the pledge drive on NPR and worrying about my parenting skills. This is not really anything new. Many mornings – and afternoons and nights – I wonder what I’m doing wrong. When I fired up the computer and started my day at the office, I received an email from my husband. His musings on our current parenting situation took the form of a faux “Dear Abby” letter. “What do you do with an 11-year-old that has everything and lies all the time?” My musing took the form of a counseling session in my brain. Taking stock of where our boy is and how we handle things. “And how does that make you feel?” Actually, my husband’s approach seemed more apt. It sent me on a googling quest to find out exactly where we stand and what we should be doing.

It was harder to find information than I thought, at least anything definitive. There simply is nothing definitive about prepubescent boys.

What I did find out is that we certainly are not alone. A lot of people don’t know what to do with these boys. We have a boy that doesn’t want to do homework and lies on a regular basis. Yeah, well join the club! The answers to the posted questions fell into two groups: “It’s the age, don’t worry” and “Have you spanked him?”

Overall it made me feel better. It also made me feel a little self-righteous, if I can admit that. We are strict parents. We expect a lot out of our boy. I would read posts about other kids and the issues other parents had and think “that wouldn’t fly at our house!” Then I got this tip from one of the more touchy-feely sites:

“Try to find out from other parents what limits they are setting and remember that if you are too far away from what their friends’ parents are doing, you will have much more difficulty in getting your teenager to cooperate with you.”

That is true and all well and good, but quite frankly, I think my standards are higher than most. We don’t let our boy watch or read or play games that other parents will allow. We expect homework done before play. We expect the bad grades that are brought home to be redone on the weekend. We limit screen time. We do this regardless of what boy’s friends’ parents do.

That made me think about his friends. In comparison, I think he is pretty good kid.

He does hate to do homework, though and I am tired of all the arguing and debating. So, we are making him more responsible for it. He has to show us his assignments and we help him budget his time, but he does the work on his own. I am no longer checking it and telling him to correct it. I just make sure it is done. We have told him that we will check it or help him if he asks. He has yet to ask. We are still battling with getting straight answers on what homework he has, however. Like last night, he was asked if he had math homework. The answer was, “No, I mean yes, a little.” He did his math. Then when he got home from practice we were going through his things and I found his Social Studies book. I had asked about math, so he didn’t bother mention his other homework. I consider that a lie. I told him so. He is a master at maintaining deniability. He had to stay up late to finish the work. But, what should the consequence be for lying? Do you deal with each of these incidents of lying as individual events, or do you let them “stack”, with each occurrence adding to the whole, incurring greater and greater consequences? There are a lot of occurrences. It is something we have battled with always. He lies like it is nothing. Thankfully, he’s not very good at it. We always know. We tell him this – you will always be found out. We reason with him, like those websites tell people to do, that in the end it is better for him to just tell the truth upfront. Yet, there should be consequences. What should the natural consequence be? A failing grade when he doesn’t do his homework because he decided not to tell us he had it? Yes, that seems logical, but does it serve his best interest in the end? Do I let his grade fall in school which would trigger more serious consequences like pulling him out of the sport that he loves? Should I pull him out of his sport anyway so he can have more time for school work? But, he is 11, he needs the exercise. If he doesn’t get the exercise wouldn’t it be harder to get him to settle down to do his work? And just think, puberty is around the corner. Lord help me!

I just don’t know the answers. It is such a balancing act. He needs independence. He needs to learn responsibility. How can I make him want to learn? How do you set goals, consequences and discipline and maintain an open, good relationship? Every day his friends are more important than we, mere parents. I feel lucky when he tells me things that he has talked about with his friends. I still have those moments. We still have our little rituals together, something as simple as watching a show together on the weekend or sharing mutually loved music on the way to school. (Thanks Beatles Rock Band for making the Beatles cool to this generation!) How much do those moments weigh when balanced against all the other influences? I don’t know that either, but I do know that keeping those lines of communication open are crucial. Our window of influence with him is so small, when you really think of it. He will be heading off on his own to college before we know it. Will he remember that I screamed at him to pick up the towel off the bathroom floor or will he remember how I told him to make a to do list? Or maybe he will just listen to the Beatles every now and then and remember that all we need is love and he will remember that I do love him – and that I tried my best and did the best I could as a parent. Maybe that will be enough.

sprouts of weeds

So, more news on pot:

http://www.nytimes.com/2009/10/28/us/28pot.html?_r=1&th&emc=th

The Govornator is interested in a “robust debate”.  Great.  Some of us have been having that debate a long time.  I remember (showing my age here) an old SNL sketch from the ’80’s when it was still called Saturday Night Live.   A. Whiteny Brown was a guest on Weekend Update and he proposed growing and taxing pot – and that it should be an export.  It would solve any trade deficit and dumb down the rest the world.  I thought it was hilarious and a great idea.  Finally, its time has come.

All we are saying is give pot a chance

It seems totally obvious for the Justice Department to have the new policy of not prosecuting medical marijuana users/growers in states where it is legal to do so. Well, duh. That never made sense to me, especially as it was the Republican administration imposing Federal law on States. Wait, aren’t they for state’s rights? I guess they are only for state’s rights when it fits their world view.

I am thrilled by this. I do not live in one of the 13 states that have passed medical marijuana laws. I do not have cancer or another ailment in which marijuana would be helpful. Still, this is such a step in the right direction. Let’s leave off the discussion of the effectiveness of prosecuting minor marijuana possession with long jail sentences for the time being. Let’s just look at the medical side. Given the Justice Department decision, it seems possible that there could be a chance for medical marijuana laws to be passed in other states. It lends credibility to the use of the drug. It gives me hope.

The state I live in is about as conservative as you can get and there is no way that medical marijuana is coming here any time soon. Still, I hope. And I do hope. I have a friend with cancer. She is undergoing treatments currently and has lost twenty pounds already. She cannot eat. She cannot sleep. Her support group begs her to eat. She eats – then loses everything she eats. We beg her to drink fluids with the same results. She is at work – not wanting to risk her job or her insurance – but in the bathroom throwing up four or five times a day. She is on prescriptions to help her sleep, to help with the nausea and to calm her nerves. All of these drugs cost a fortune on top of the already expensive chemo treatments. It is a drug company’s dream. A patient needs a treatment that makes them need a bunch more. The thing is; they really don’t work. Obviously. If they did, my friend wouldn’t be in the bathroom right now throwing up the breakfast I made her eat.

You know what really just pisses me off? Her doctor told her that if she lived in California he would prescribe her with marijuana – for nausea, to help her sleep and to calm the anxiety. In other words, it would replace the three prescriptions she is taking and paying for now.

I don’t like Stan

You always see guys like Stan in movies or on TV but it never crosses your mind that there might really be people like that.

My wife’s phone is supplied by her work so mine is on the same network.  When her company switched to AT&T, I naturally switched also.  We decided to take this opportunity to get our son a phone also.  My wife scoped out their plans online then we went to the AT&T store.  The minute we walked in the door we were accosted by Stan, clipboard in hand.  He asked what we were looking for and, before we could answer, he asked her what her plan was and what her name was.  I cut in and told him that we just wanted to look at phones right now.  He wanted her phone number and she explained that she wasn’t getting a phone, she had one.  He wanted to know what her phone was.  She told him.  He still wanted a number.  She gave him mine.  He had this obnoxious habit of being in your personal space.  It was claustrophobic.

As we went to the phones he wanted, again, to know what plan we had.  My wife, exasperated already, explained that WE had NO plan but that her company had a plan and we were switching me to that plan.  My wife works for a prominent local company so he wanted to know what she did there.  She answered only vaguely – an answer I knew meant that it was none of his business – and we ran him off long enough to look at phones.  He was disheartened when we told him we wanted just basic phones.

He went to his computer and looked up plans and phones.  When she explained that she’d seen free phones online, he pulled up the page and the free phones were on the top of the page.  He scrolled down and she told him to scroll up, please.  He ignored her.  She asked again.  Finally one of the other employees explained that the free phones were discontinued phones, could be ordered (they didn’t have any in the store) but that accessories , like chargers, might be hard to find.  Fair enough.

Stan had now moved to the website of our former carrier, and wanted her to log in to get the account number, a necessary step to change my phone over.  He was talking faster and being more insistent by the minute.  My wife explained that she did not know her password as she never visited it.  He asked her to take a seat in front of the computer and try to log on.  She did but was unable. Undaunted, he said, ”why don’t you call customer service?  It’ll only take 2 minutes”.  She informed him it never took just 2 minutes to call customer service.  He was standing over her shoulder and he was actually getting impatient with her!

She said, “You know what?  We have to go pick up our son.  Why don’t we do this tomorrow?”  I winced.  I could see she’d had all she was going to take.  Stan countered with, “How about I set you up with two phones with temporary numbers then…” She cut him off and said ,”No.  We’ll come back”.  Before letting us go, he insisted on giving us his card and circling his name.  I couldn’t help but think that surely he knew we would never do business with him.  Was he that thick?!  On the way out I said, not quite under my breath, “I don’t like Stan very much.”  Except, I think there were actually some expletives involved.

Once in the car, my wife used her phone to look up the location of another AT&T store – one without Stan.   She said we would go there tomorrow and get phones.

But the story doesn’t end there.  Today, Stan called me and wanted to know when we were coming in!  I told him I didn’t know; we were busy.  He said, “You have my information, right?”  I assured him I did.  He added that he wondered what he needed to do to “get us onboard”.  I hung up.

Stan aside, we don’t even want to be with AT&T but it makes the most economic sense for our family.  Ironically, we ended our phone service at our home with them about the same time we found out my wife would be getting her work phone through AT&T.  We had wanted to cut ties with them because they donate heavily to the Republican party.  Again, it came down to the best deal for us.  We ended up getting our phones at another store and learned why Stan felt the need to be so aggressive.  There are strip centers on every corner of the intersection and in three of the four there are AT&T stores.  Three stores within blocks!

I can’t wait for Stan to call me again so I can tell him I went across the street.

Thankful, but wondering if it couldn’t be better

In such a difficult job market, I wake up every day thankful I have a job. Very thankful. My husband leaves the house at night and is thankful every night he has a job. We get it. We’re fortunate.

Still, he works at night. I work in the day. I work Saturdays. He works Saturday night – which means he sleeps most of Sunday. By the time he is up, my weekend is, for all intents and purposes, over. Our son and I go to bed Sunday night in order to get up Monday morning to start all over again – just as my husband is starting his weekend. We make it work. We look at the bright side of things, such as; he is home when our son gets home from school. He is up in the afternoons to take him to practice when I have to be at work. It works. Things are good.

Still. No weekends together, while we understand it is a luxury, would be nice. I was off work this Saturday and he took off work. He had to work extra to get someone to work for him and it cost him a day’s pay for our family to have 48 hours together. We spent it camping, in the middle of nowhere, no phones, no TV, no distractions except a campfire and smores. It was the best weekend. I feel buoyed by it, like I have something to hold on to for a while.

Thinking about this: How we have nothing to complain about. How important the weekend was. I began to wonder if what I thought of as a luxury – time together – wasn’t really more of a necessity. We need our jobs. We have to work. We want to provide our son with a good life and save for his college. We want to put a little away in the thoughts we will retire at some point. Still, what are our priorities here? My husband works in a position where they have had a difficult time keeping anyone. People work there and then quit. Gee, I wonder why. Wednesday through Saturday at night (10 hour shifts). It eliminates the weekend and makes family or social life difficult. Still, that is the way the schedule is set and they would never consider altering it – they will just keep the revolving door open where they train a person, the person works, the person quits, they train another person. Except now, with the job market so difficult, they will keep the employ and he will just be miserable. He is happy to have it after being laid off due to downsizing. But is it sustainable?

Couldn’t it be better?

Everyone, no matter how lucky they know they are, no matter how thankful, can use a break. Just a weekend here or there.

Ironic Elementary Jingoism

My son’s mostly-Caucasian-muttism puts him in the minority at his school. The demographics put nearly half of his classmates as Asian with Hispanic and African American comprising another 20%. There are over 70 countries represented and the annual multicultural night is not a fluff piece of “It’s a Small World After All”. Rather, parents and students proudly present music and dances from their home/ancestral countries. We love this about his school. We love that when he hears a story on the news that involves South Korea or the Philippines or any number of places, he will ask how it effects his friends’ families. In a world of such diversity, we also try to teach him to embrace his own little portion of Cherokee blood with a sense of pride.

All of this serves as a background to the assignment he brought home this week. They have been studying the explorers and colonization of the Americas – although I don’t think I have yet seen the word “colonize” on any of his homework sheets. In conjunction with this, the reading assignment he was given was about a day at the mission. It explained how the long-suffering padre did his best to teach the Native American’s the European way of planting, tanning leather, woodworking, sewing, dressing, and eating. The day started off with him trying to teach them his religion. At the end of the day, at the end of the story, he closed the gates to a mission and vowed to try again the next day. The implied superiority of European ways, the paternalistic tone, the implied notion that the Native American’s were unable to care for themselves – all of it was offensive to me – and to my son. I sent an email to the teacher pointing out the inherent misperception the story gave. I also pointed out the irony of presenting the story the week they are preparing for multi-cultural night and the double irony of the school being predominately NOT of European decent. In reply I have been assured that they will not be using this story in the future. Nevertheless, the episode speaks to how easily history can be stilted when we white-wash (pun intended) away all the ugly parts before we present it to kids. It is much more difficult to teach that the native populations of the America’s were decimated by disease and massacre on the arrival of the “white man”. It is easier to say that the Europeans civilized the tribes than to explain how they destroyed Indian’s social, political and religious structures. Kids are more able to understand these things than we give them credit for and we shouldn’t hide the ugly parts from them.