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Archive for the ‘Observations of America’ Category

M was home yesterday when I got some bad news, and he got the full force of my anger and frustration.  It wasn’t fair to take it out on him — he’s got enough on his mind at the moment — but he was there.

He was there because his company had sent him home with no hours.  Again.  It’s become a regular occurrence these past four months.  Every week like clockwork, when the pay-week comes to a close on Thursday, he gets up and gets ready, gets in his truck and heads out for work, and then they send him home with no hours.   Since the beginning of December, he’s had only three weeks of full-time hours, only three paycheques that really cover the bills.

My birthday is coming up in the next couple of weeks, and it’s a big one.  Apparently, Life Begins at this age.  M may be all manner of wonderful things, but he is not good at remembering me when it comes to  important occasions — I have not had a birthday or Christmas gift from him for three years running — so I have been reminding him of this impending event almost every other day since before the turn of the year, like a count down.  This is a Big Birthday, and I do not want to be forgotten this year.

I had emailed out my birthday wishlist to everyone who would likely find it useful but, knowing that M uses a computer about as often as a camel uses an umbrella, I have been coaching him separately for a long time.  More than anything, I want a Lendrum spinning wheel to replace the ancient, second-hand wheel that I have been using (and which has served me well) for the past 12 years.  But a shiny new Lendrum is nothing to be purchased lightly — it’s $622 — and so I’d hoped that maybe if everyone pitched in together, then what remained would be more within our grasp.

And just the day before, I’d made a furtive phone call to a local yarn shop to see if there were any places left on the knitting class they were offering this month with knitting guru Brandon Mably.  I had already taken this same class  six years ago — it was a treat to cheer myself up after I miscarried our first child — and I had enjoyed it so much out of it that when I saw that he was coming to the area, I immediately began to muse over taking the class again.   It was an expensive class, at least for me…  The amount left each month for spending money for me and the girls rarely tops $50 — and that includes everything: shoes, clothes, magazines, coffee — and this one class would blow that out of the water, but how often does one turn…  erm…  How often does Life Begin?  I felt guilty making the call to the yarn shop and I felt guilty at the thought of booking the class…  But there were spaces left!  And I wanted to take it — I really wanted to!  I decided  I’d wait a couple of days to be sure the idea settled right, and then — damn it! — I’d do it!

Yesterday morning I received a bill from the doctor’s office which treated my sprained ankle.  It wasn’t for much — almost exactly the co-pay amount — and so I assumed it was an error.  Somehow, the insurance company must not have realised I’d paid the co-pay on the day, so I picked up the phone to sort it out.  It was a beautiful day, sunny day and my husband was home — I’d get this out the way, it shouldn’t take long.

The lady on the phone sounded weary.  “That’s your deductible amount,” she explained, and then added, slowly and with a tinge of irritation, “You’re responsible for the deductible.”

“Oh, I know!” I said with deliberate cheerfulness, because the lady sounded like she needed it.  “I understand we pay the deductible but… I’m confused…  Before I went to the doctor’s, I spoke to a lady in your office who explained that my husband’s employer pays the first $1000 of the deductible.  Have we gone through a thousand dollars in two visits…?”

She tapped on her keyboard and then paused.  Then a deep breath.  “No, but I’m afraid whoever spoke to you got it wrong.  You’re responsible for the first thousand; your husband’s employer pays the second thousand.”

Oh.

My stomach dropped instantly, and then my mind began tallying, very quickly: doctor’s visit, three x-rays, the airboot, follow-up visit, three more x-rays, the lace-up brace…   How much had we run up?

The lady was tallying too.  “We’ve negotiated a nice discount for you on that bill…”  I could see that they had indeed — they’d reduced the bill by 75%.  “And I can see that you’ll also be receiving a bill from a rehabilitation equipment company…”  Yes, that’d be the airboot.  She told me the amount, and I winced.  “And… let me see…  another bill from the doctor’s office…”  The follow-up appointment.  “And another… oh, from the equipment company again.”  That’d be the brace.  “Let me add that up for you, ” she offered helpfully, her irritation subsided now that she realised I wasn’t going to put up a fight.  The amount came to around $400.

Four hundred dollars…  for one moment of stupidity.  Four hundred dollars, after months and months of short weeks and short pay.  Four hundred dollars!  If I had known that, I never would have taken off the tape that was holding my ankle still and let them replace it with a brand-spanking new lace-up brace.  If I had known that, I would have paused at the offer of the airboot, and grabbed my mobile to ask my mother if her old airboot would fit my foot.  If I had known how much it would cost us, I honestly think I might not have gone to the doctor at all — certainly not to that follow-up appointment.  M had said it was only a sprain and it would heal on its own, and he was right.  I could have gotten by without the doctor.

The day had seemed to have suddenly lost all its sunniness…  I felt sick to my stomach (again! again!) and deflated.  My hoped-for birthday gift now sounded extortionate, and the thought of booking that Brandon Mably class seemed frivolous, if not downright irresponsible.  Spend money on my birthday like that?  Spend money?!? What fool thinks she’d get to spend money on a milestone birthday?!?

And with that, deflation turned to anger — real, seething, boiling, red-hot rage — and  so I yelled.  I yelled and I yelled and I yelled at this country, at this joke of a “system”, at the waste and the complication and the confusion and the callousness of it all.  I yelled at the lack of transparency, at the miscommunications, at M’s lack of hours, at his too-short paycheques when he works so hard, at the recession, and at the ludicrous idea that somehow this is all ok, that this is the American Way.  I yelled because, apparently, going to the doctor when I sprained my ankle was my birthday gift this year.

M thought I was yelling at him.  And he came up and held my hands and, with tears in his eyes, he said, “Your birthday will be alright.  We’ll make it alright.”  And then I felt terrible for all the yelling, and tears came to my eyes too.  Sod my stinkin’ birthday — what I’m really scared of is losing the house.

The door woke me when M left this morning: 6.11am.  That’s early, I thought, and then drifted heavily back to sleep, hopeful that it meant he had a busy day scheduled.  He was back home again just after 1pm, having worked three hours, and then hung around for another three in the hopes that some more work would come in, before he finally gave up and drove back home to us.

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Something I Miss:

The chemist’s shop (pharmacy) in the little town where I lived in the UK was a step back in time, and delightful and frustrating for it in equal measure.  If it had disabled access, I was unaware — all I know is that it had a narrow doorway and an awkward step that was incredibly difficult to manoeuvre with a heavy pushchair.  The hours were posted on the door: Monday – Saturday, 9-5; closed for lunch from 1-2; half-day closing on Wednesdays.

Once inside, there was an old glass-and-wood counter on the right from which you could buy magazines, cigarettes, wine and whiskey, or sweets.  To the left was a rabbit’s warren of shelving units — packed so close that the pushchair only just fit through — offering a dizzying array of almost anything a person living in a small town might want.  The carpet was trodden to a manky brown-grey by a thousand muddy boots, and jarred with the sleek and brightly lit cosmetics displays.  The place smelled musty, always, as if what it really needed was for someone to throw open the windows and let the wind blow through.

At the far end of the shop stood the chemist’s counter, with the traditional set-up of the cashier’s till at the ground level where the customers were, but the chemist (pharmacist) work up high on a raised dais.  The chemist popped down regularly to answer questions and give advice any sort of ailment that was presented — in the traditional role of a sort-of doctor’s stand-in — but then went back up to the solitude and privacy of the mezzanine to work in peace.

The cashiers knew our names — it was a small town, after all.  They saved my favourite magazines for me.  And the prescriptions — every one and every time — cost £7.20.

Something I Love:

Here in the US, the girl’s doctor asks me which pharmacy we use, as she peers squinty-eyed at her computer screen.  I tell her and she taps in the prescription.  “Are you going straight there?  They’ll have it ready in about 20 minutes.”

When we pull up, the girls are asleep, exhausted from the adrenaline kick that a visit to the doctor’s always brings, so I go round the back to the drive-thru.  The cashier doesn’t know us, but she checks our insurance card and, as promised, the prescription is ready, all packaged up in its paper bag and waiting for us to collect it.  There are two more refills, and the pharmacy will hold those on file until I ring next month to say I am ready to drive-thru and pick those up as well.

And the girls sleep on — undisturbed and unaware — and I marvel at how easy this is.

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“The good news is…”  I could see from the x-rays up on the lighted board that there was no break.  “…that I don’t see a break or a fracture.  The bad news is that’s about as bad a sprain as you could have done.  It’s going to take a long time to heal.”  The doctor scrunched up his nose in hard-luck sympathy and his wire-rimmed glasses rose up a bit above the level of his eyes.

“We have a few options.  We could put you in a traditional cast, which would hold everything still and help you to heal the fastest — but it’s not that nice for you.  Or we could just leave it alone and let you walk on it, but that’s pretty painful and you’d end up not being very mobile.  Or, I could give you an airboot, which is a middle ground between the two.”

He held it up — a huge great ugly cross between a ski-boot and something a StarWars Storm Trooper might wear.  I pulled a resigned smile, “Sooooooo, I get the big dorky boot then…”

“It’s not dorky!” he defended.  “They’re quite good really…”  He looked down, turned it over in his hands.  Focusing on the medicine, he missed that I was thinking of my vanity.  “You’ll need to wear it most of the time, to start.  It will be a while before you drive.  And expect it to take four to six weeks before your ankle is fully healed.”  Four to six weeks!  For one moment of stupidity!!!

After the doctor left, the nurse gave me a resistance band and showed me a few exercises.  The he put my foot in the boot and explained how to put it on, how to inflate the sides so it supported my ankle.

“Where are your shoes?” he asked, looking around the room.  I pointed to my Dansko clogs in the corner.  He looked alarmed and spoke sharply,  “You need to stop wearing those!”  And, shaking his head, he added, ” They’re death-traps!”  I knew he was right but, to be fair, they were the only shoes I could fit my swollen foot into that morning.

When we were finished, he walked me back down the hallway to reception.  The doctor was right — the airboot was quite good really.  I was hardly a picture of grace, hobbling as I did, with my right foot clomping loudly with each step, but my ankle hurt an awful lot less with the support of the boot, and this had been a walk I had barely been able to make just an hour before.  I suddenly felt a surge of excitement.  I could get around again! I had my autonomy back!

Vanity may be over-rated.

— a walk I had barely been able to make before

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This morning, when the pain was a little less of a shock and the cold shiveriness had passed, I was better able to assess the situation.  The night had not been good — there was no comfortable position to lie in, and so sleep came in fits and starts — but the situation seemed better… and worse.

On the plus side, I wasn’t as limited in the positions I could hold my foot in.  I could lie with my legs outstretched and my foot falling forward naturally, and  rest my leg to one side without too much pain.  I could adjust my hips or even turn in bed without gasping from the shock of it.  But where I could put weight on the foot last night and hobble forward a few paces, that was now impossible.  There was a pain running up my shin that I hadn’t registered before.  And the bruising was coming out, which always makes things look downright alarming.

My mother watched me crawl — and gasp — my way to the loo and asked, shouldn’t we maybe have that looked at…?  Maybe it was broken?  Mmmmm…  she might be right

I rang the insurance company to find out what they covered and where we stood.  Now that it’s not an emergency, the lady explained, they preferred that we see a doctor before going to hospital.  Yes,  the doctor my mum had recommended did participate in their plan.  Yes, they would cover all the scans and tests he might feel were necessary.  There would be a $40 copay — I knew that already and, even though that’s a significant sum to us at the moment, we could handle it.  And, she continued, there was a deductible we had to cover before the insurance began covering the costs.  It was…  the lady on the phone paused, looking through the numbers on her screen…  It was $2,000 — my heart skipped a beat — but… she looked at the numbers again…  M’s company paid the first thousand.

Ok.  Ohhhh-kaaay…  Just at the moment, having to pay almost any part of that deductible would be difficult, but that little gem about M’s company might save the day.  I looked at my ankle and began to tally: x-ray… MRI…  What might the doctor order?  How much do these things cost?  I don’t have a clue — it might well all come in under a thousand or we could just as easily blow right past it.  I really don’t know.  But — oh! — that swelling just did not look good!

My mum rang the doctor to check if they had appointments available.  The earliest was not for two days and, phone still to her ear, she raised her eyebrows to ask…  Did I want to take it?  I paused for a moment…  wiggled my toes and winced.   Yes. “Yes,” I said, looking back up to her.  “Make the appointment.”

The ankle is painful but stable, my mum is here so I can rest (thank goodness for her!), and the two-day delay still allows us 48 hours to watch things and decide if the appointment is necessary.

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When I heard the snap, I wondered if that was the sound of my bone breaking…  though I quickly realised it might have been the sound of the chair that I fell onto, or the door it slid into, or the stair-gate that took part of my fall.  The pain in my ankle was so intense that I just couldn’t tell, and sat there on the floor instead, unable to speak and taking in great gulps of air and letting them out in silent, open-mouthed, chest-wracking sobs until M finally realised that I’d really, really hurt myself and came rushing over.

He thought it was only a sprain, but he wasn’t sure either.  He pressed gently there… and then there… and I squealed, squirmed.  Eventually, I worked up the courage to try to move my toes: pain shot fresh up the leg, but the toes moved.

“It’s probably a sprain,” he announced, and then paused… and wavered.  “But perhaps we ought to go have it scanned, just in case…”

We’ve not really used our health insurance much, he and I.  We’ve used the girls’ insurance plenty of times in the past two years so I know how it works, but we’ve hardly touched ours and I’m not totally confident about what’s covered or how.  “I… don’t know what our copay would be for a hospital visit,” I said.  I looked at my ankle, considered wiggling the toes again…  “Grab your insurance card, would you?”   It listed the copay amounts for a doctor’s or specialist’s visit but, maddeningly, not for a trip to ER.  What it did point out, right at the top of the card, that we were covered for ER trips for “life-threatening and emergency” situations but would have to pay extra costs for anything else.  And I wondered, did a broken ankle count?  If it turned out to be a sprain, would the insurance company accept that there was a chance it might not have been?   Simply put, would they pay?  I wasn’t sure.

I handed the card back to him.  “Let’s wait awhile and… well, let’s just  see how it goes.”

Time seemed to confirm our decision.  A massive goose egg appeared and, eventually, I could put a bit of weight on it…  gingerly… gingerly… and make it as far as the loo — a good sign, though it left me exhausted and shaking.    We agreed that couldn’t have been done on a break or a fracture, and both felt a bit better about the decision to stay home.

M rang my mum and arranged for her to come round tomorrow and take care of the girls.  Thank goodness for my mum.  9am?  No, 8am, please — the girls do sleep late, but one or the other  always wakes early and asks for the loo and I can’t move at all.  How about 8.30?  No, 8… please.

When he got off the phone, he came and sat next to me, took my hands in his, looked a bit sheepish.  “I’m sorry I can’t take the day off tomorrow.  You know I would…”  I know, I told him.  But we can’t afford a day without pay.  Between the economy, all this bad weather, and his operation, we are on our ninth week of below-subsistence pay — we most definitely cannot afford a day without pay, and we both know it.  And then I thanked God it was my ankle swelling up and not his.

“If we were in Britain, I’d take the day off.  You know that, right?  I’d take a couple of days off!”   He felt really bad about this, I could see.

“I know.”  My injury, his injury, pain, illness, family emergency…  there is no room for error — no matter what, his job must go on.

He pulled a tight smile, rueful, and looked away over my shoulder.  “If we were home,” he continued, “we’d have gone to hospital, had you checked out…”

“I know.”   A medical decision based on cost, a chance for early treatment lost to financial constraint — it’s how it goes.

And the moral of the story?  The lesson to take away?  It could be about the system, but that’s all been said before. Today, the lesson is a personal one: do not climb up on your daughter’s rocking-balance toy to demonstrate how she can pretend to snowboard along with the Olympians on the telly.  Because you’re staring down the barrel of 40, my dear, and when you take a mis-step getting back down… well, your body just doesn’t bounce back the way it used to!

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When we first moved into this house, we debated about ripping the carpets up and finishing the hardwood floors.  I knew they were diamonds in the rough.  I wanted to do it — really, really wanted to do it — but everyone else was against it.  M thought we didn’t have the money to spend (and, to be fair, he was right).  My dad couldn’t understand why I didn’t want to “just move into the house and enjoy it, as he would.  And my mum was adamant that hardwood floors are so much harder to keep clean than carpet (but the truth is she just doesn’t much like hardwood).

In the end, I listened to none of them, and I have never regretted it for a minute.  Not only because they are gorgeous, gorgeous, gorgeous.  And not only because I realised with hindsight that, with her allergies and asthma, E2 probably would have suffered a lot more with carpet in her room than she is with that nice clean hardwood.  And not only because there were quite notable decreases in M’s migraine and sinus problems first when we moved to the States and changed to forced air heat, and then yet again when we moved to this house with its hardwood throughout.

No… no… not just for all those reasons.  No, I was so glad that I had decided to go ahead and rip out the carpets, to listen to my gut and get the hardwood finished all though the house…  I was so glad today, as I followed a little trail from one room of the house to another…  A little trail of neat little brown plops of poo — one every few feet — which led me through three rooms and finally ended at a pair sagging, straining training pants, filled way beyond their capacity, employed far beyond their remit, by a little girl who had completely forgotten that she wasn’t wearing a nappy and is now supposed to use the toilet instead.

I lifted her in one swift motion and deposited her — clothes, socks, training pants, and all — straight into the bathtub, and ran downstairs to quickly collect the plops before someone else unknowingly squished them underfoot.  And, as I gathered them up easily with a damp cloth and some disinfectant — to the panicked howls of  “But Mummy I am still wearing my clothes!!!” — I thought back to my mum’s argument…

When she said carpet was easier to keep clean, she was never imagining this.

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…I laid in the near-dark, feeding E2 down for the night, her little body curled into mine, and me drifting in and out of semi-sleep as she fed…   I pulled the covers a little tighter over the two of us, and allowed myself to drift back into sleep for a while longer…

Yada yada yada.  Thanksgiving was on Thursday and, let me tell you, I love me some Brussels sprouts.  Love ’em.  Ate tonnes of them.  A-a-and they’re still working their way through my system.

So, tonight,  as we lay on the bed, I curled my sleeping daughter into me and gently drifted off… once again, that most perfect, peaceful moment…

And then I trumpeted so loudly that I scared myself bolt upright.

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