Friday, August 28, 2009

Carnival of MS Bloggers #43

Welcome to the Carnival of MS Bloggers, a bi-weekly compendium of thoughts and experiences shared by those living with multiple sclerosis.

Yoga, Tysabri, and Insurance


When I teach yoga I like to give freely of myself, to nurture my students and to help bring them closer to their true selves.

Nevertheless, I get as much out of my teaching as they do. Teaching yoga gives me a home, a place of sanity to stand when all I want to do is howl at the moon. It reminds me to breath. It reminds me of my favorite prayer by Saint Francis of Assisi:

"Lord make me an instrument of thy peace
Where there is hatred, let there be love
Where there there is injury, pardon
Where there is doubt, faith
Where there is despair, hope
Where there is darkness, light.
Oh divine master--
Grant that I might not so much seek to be consoled, as to console
To be understood, as to understand
To be loved, as to love
For it is in giving that we receive,
And it is in death to self
That we are born to eternal life."
Amen.

My heart is filled with gratitude for the things I receive from teaching yoga. I bow to my students. I bow to the teacher in all things. I prostrate myself to the divine with the faith that I will find a way no matter what.

Let yoga be your candle in the dark.
Let it lift you and fill you.
Let it in inspire you
Take what you discover on your mat into the world
And create peace, love and harmony.



At my last neuro appointment, he and I had a talk about how my MS is getting worse and how he and I believe my current therapy (then), Betaseron, just wasn't helping. I told him that I wanted to start Tysabri infusions and he agreed.

Problem is, I have Medicare but no supplemental insurance. The Infusion Center figured that my co-pay would be $575 every four weeks. There is no way in hell that we can afford that kind of money, I don't care how good the drug works.

I contacted TOUCH, and they put me in touch with NORD. I got paperwork from NORD yesterday, and we'll get it filled out and make copies of our financial records, hoping that they will cover my co-pay.

If I do get to go on Tysabri infusions, it will be wonderful. I honestly believe that this drug can help me.

If I don't, I'm not going to get depressed or sad. I will just continue on with my life, deteriorating toward who knows what. I will be DMD-free, anyway.

In other news, I was invited to join a book club--my first ever. Our first book was Travels With Charlie by John Steinbeck. Loved it. We meet every other month at a nice little restaurant that is closed for lunch during the summer, except for the book club. We have great food, good discussions, and lots of laughter. Three of the women in the club (including me) have Saint Francis service dogs. The woman who started the club is also the woman who co-founded Saint Francis. There are 10 of us, and everyone is nice and friendly. Our next book (just started reading it today) is The Good Earth by Pearl Buck. Think I may have read it in high school, 40+ years ago!!


I have also volunteered and been accepted to be on the Outreach/Screening Committee for Saint Francis. Eventually, I will be calling people who have applied for a service dog, asking them questions and talking to them about the responsibilities and hard work that goes into training with your dog. I will sit in on interviews of people who have passed the screening, and I'll have imput into whether or not I believe they would be a good candidate for a dog.

These two things are giving me something to do outside of the house, and also giving me a sense of accomplishment.

Next Saturday is my 40th high school reunion. I am very excited about it. This is the first one I've ever attended. There are a group of us who have kept in touch through the years who are all going to sit at the same table. Next morning, this same group is meeting for lunch and talk. There are so far 45 graduates (plus spouses) who have signed up to come. My class had about 125 people in it, so that's not a bad turnout.


Getting Squeezed
by Lisa of Brass and Ivory

This week I received the annual note from Carefirst BCBS, my insurance company, informing me what my new health insurance premium rate will be for the upcoming 12 months. Of course, I expected that it would go up, no matter how I wished it wouldn't.

What I didn't expect was HOW MUCH it was going up!! 31% increase

OK, so it's not the first time the rate has gone up substantially -
In 2003, it was 22.2%. In 2004, 18.2%. In 2007, 19.9%. In 2008, 18.8%.
(see graph below)

But COME ON. Enough is enough. another 31%?

For insurance which doesn't pay for my MS medications, I will be paying $5172?

That's just for me, no one else, and is not subsidized by any employer since I am self-employed. And unlike most folks who have employer-sponsored health insurance, I will be paying Social Security, FICA, etc taxes on that $5172.

Why doesn't Carefirst cover my main MS medication, Copaxone?

  • Because the drug benefit for individual policies is capped at $1500 annually.
How do I get Copaxone if insurance doesn't cover it?
  • I have to qualify for assistance from NORD which administers the PAP.
How do I do that?
  • I must earn less than 200% Federal Poverty Level (FPL) and can't have significant amounts of money in savings.
How much is 200% FPL?
  • This year (2009), it is an Adjusted Gross Income (AGI) of $21,660.
For more on this story, see The Value of Money or Value of Health: What Do You See?

Now, to be fair, the $5172 in insurance premiums will not be 24% of my 'total income.'

Since I'm self-employed, I get to deduct the amount spent on health insurance premiums before income taxes are calculated. So it's a minimum of 19.3%, after Social Security/FICA tax is accounted for and before the AGI is calculated.

But, please tell me. Who can afford to spend 19-24% of the highest level of income they can afford (or are allowed) to earn for health insurance premiums?

And let's just say that for 2008 I did earn considerably less than 200%. In fact, $5172 really would be closer to, if not more than, 25% of total income.

According to proposed health care reform legislation, affordable premium rates for someone with my income level would be closer to 5% of income AND I would very likely have coverage for my medical needs, including pharmaceuticals.

A few weeks ago, I sat down and calculated what medical expenses were included during one year in obtaining the routine care I require. That detail can be read at Living with Multiple Sclerosis: The Cost of Chronic Illness.

Update: Now it looks like the Public Option just might get dropped during negotiations in Congress. sigh.


This concludes the 43rd edition of the Carnival.

The next Carnival of MS Bloggers will be hosted here on September 10, 2009. Please remember to submit a post (via email) from your blog of which you are particularly proud, or which you simply want to share, by noon on Tuesday, September 8, 2009.

Thank you.
Comments for this post.

Thursday, August 13, 2009

Carnival of MS Bloggers #42

Welcome to the Carnival of MS Bloggers, a bi-weekly compendium of thoughts and experiences shared by those living with multiple sclerosis.

Weight, Death, and SSDI

MS and Fat by Christina, submitted by Barbara

When Marianne asked me if I would like to write a piece for The Rotund, I started to freak out. Of course I am honored to have the invitation, but I haven’t written about being fat in a while and wasn’t sure I had something coherent and concise to say. But the truth is, I live as a capital-F Fat woman everyday and in every single aspect of my life there is conflict with that, including my Multiple Sclerosis (MS).

Diagnosing MS can be very difficult due to the wide range of non-specific symptoms. Most people with MS report having symptoms for years before getting a real diagnosis. For me, it has been at least 6 years since I first showed signs, yet I have only been diagnosed for 4 months.

One of the major hurdles for me being diagnosed is because I am Fat. No, the hurdle is not my beautiful 300-lb body. The hurdle is the intense, institutionalized fat-hatred common in the American medical establishment. Thanks to the “obesity-epidemic” whenever I visited a doctor, the cure to all my worries was weight-loss. Whether it was burning pain in my legs, numb fingers, exceptional fatigue, and even blindness in my left eye, according to the doctors, all I needed to do was drop a few (or 50) pounds and it would all go away.

I actually did it, too. I figured, it couldn’t hurt. But it did. I was so focused on getting rid of my symptoms through weight-loss that I ended up doing real damage to my body and mental health. And surprise, surprise, even after significant weight-loss, my symptoms were just as bad, if not worse. You wanna know why? Because MS has nothing to do with weight.

After getting my diagnosis, I shared all these stories with my neurologist and he was shocked. He couldn’t believe that other professionals had completely ignored my classic symptoms and recommended completely unrelated treatment. “It’s like treating a broken leg with rash cream,” he said. He really has no idea how true and common that statement is for fat people around the world. Even when a person doesn’t have all the “obesity-related illnesses” some doctors can’t see past the fat.

Unfortunately, even with the diagnosis my fat becomes a topic of conversation. Just recently I had two occasions of “OMG you’re fat you need to lose weight!” My favorite response is to chuckle and say, “No thank you, I like being fat.” And once I toss a little HAES their way, they get over the hoopla, start to listen, and treat my symptoms, not my appearance. Because the truth is, weight has nothing to do with MS. My symptoms and the treatment dosages would be the same whether I’m 300 pounds or 103 pounds.

So, it would be nice not to be told to lose weight all the time. I’m over being judged by the way I look and am ready for medical professionals to accept every part of me, listen to the words I say, and provide me with appropriate treatment options. Because I deserve it.


Summer Darkness


Better Forget
by Mary E. Gerdt
all rights reserved

Hot and sticky.
The weather had finally changed from the bitter cold to now the unbearable heat.
How are we to continue to tolerate this misery?
My sweat stung my eyes as I looked to the far horizon. I shook my head to refocus.
No sign.
I look in the opposite direction.
Nothing.
Don’t think about thirst. Those thoughts would not leave me alone.

Pain.
Sometimes sharp. Sometimes dull.
Sometimes pleasurable in a sick sort of way.
Pain better than thirst.

Voices.
Were they real?
Are they friendly?
They are too far away to tell.
My voice will not respond.
I am so parched.
A little squeak.
Smaller than a mouse cry.
Smaller than a mosquito buzz.
Surely they cannot hear me.

Lights.
Are they real? Is that the sun? Or some delusions.
They hurt my eyes but I want to stare at them.
They have rings around them. Halos.
Am I dead yet?

Dizzy.
How can I be dizzy lying down?
I feel I am floating but this hard ground reminds me I am on the desert floor.
A sore nags at my back side. Pain again. Stinging.

Rushing
I feel I am rushing here and there. Flying in a way.
No pain for a minute.
Flashes and needles and little noises.
Beeping noises like a smoke alarm.
Loud then soft.
Soft then loud.

Sleeping.
How could I sleep when I am dying?
Wasting living time.
Why not when it hurts so much to be awake?

Movement.
I can’t move.
Something must be broken.
Pains here, then there, then gone again.
If I could raise an arm I could call the voices over to help.

Crying.
I feel tears drop like rain. Little sad voices overhead. Is that an angel?
Pain then none.
Sleep.
Let me go.

Remember.
Remember when I was alive and well and fighting the battles of life.
Remember when I smiled and laughed and cried and wondered.
When we loved and were loved and lost and gained.
And

Forget
Those days in ICU when my parched bloated body looked horrible.
When you saw my pain in grimaces and questioning looks.
“Why me?”
When you wondered if I had pain, was dizzy, could I cry?
Yes, but forget those days.
Better you forget.

notes: This poem refers to my projection of what an ICU patient experiences after 8+ years as an ICU nurse observing all forms of illness, delirium, end of life. There has been much MS Blogger activity discussing end of life issues. This poem is one of my imaginary ends. Not good nor bad, I guess it is some of both. mary


A Flawed System 
by Jaime

This system we have is flawed! It is not right! I understand that there are a lot of sick people in this world and the government can't afford to pay for each one of them, but there has to be a better way. We would not be on SSDI if we did not have a medical reason to do so, so why is medical not provided right away? A 2 year waiting period is not acceptable! I would not care that I have to pay a deductible, but when your income is cut in 1/2 or more because you become disabled and have to go on to SSDI to begin with and then they want you to pay another 1/3 of that just to obtain medical...that does not leave you enough to support your family. That is poverty! We deserve better than that! That is not why we worked so hard and paid in taxes, so that when we became disabled or if something happened to us we could be at poverty level. That is just NOT okay!

It seems to me that the system needs to be changed. I just don't know where to begin in starting something like that. It is not right that there are hundreds, maybe thousands of capable people out there living off of our welfare system because they don't have the qualifications to obtain a job, or because they are lazy. I am not saying every person on welfare should be thrown off...I know that some states have systems in place (Utah did it for my sister when she applied for her disability) that you go on welfare while your application is in, but once you are approved they take your lump sum to pay back what you got for welfare, so at least this gets paid back. I am sure there are other reasons someone would be on welfare that may be justified, I just don't know. I just have a problem with the number of people who are perfectly healthy and capable of getting a job and don't, but soak up the resources that prevent people who actually need them from getting them. This just pisses me off!

Like I said though the system is flawed! It does not seem to me that it is right that someone who lives in NYC on SSDI and is single gets the same amount as someone in S. Dakota who is also single. Obviously the cost of living in NYC is much more expensive and so for the system to be fair things like cost of living should be taken into consideration....they aren't! This goes the same for SSI (although it does not matter if you are single or not because there is just a flat rate for SSI. It doesn't matter how many people are in your family). For SSDI you can claim your spouse and/or children also up to a specified amount, so there is a little more you can get if you have a child or if you are married, but it still is not much and they do not take into consideration anything like cost of living. Also, if you are awarded SSDI you do not qualify for medical coverage for 2 years and then you only qualify for Medicare, which is not the greatest coverage (but, it's better than nothing). SSI people automatically get Medicaid coverage which covers them at 100% (depending on the state they may have a small copay). This piece of the system I have a hard time with also. I think it is great that these people who are on SSI have Medicaid coverage. They did not ask to be disabled and it is not their fault they were unable to work and pay in taxes, however, for those of us who did work and pay in taxes, we should be eligible for medical also and immediately. There should be one system. The system I think should be evaluated based on a number of issues. They should take into consideration the illness, type of disability, need, cost of living in the area, income, family composition, if any health care is available (some people may have coverage available through a spouse but refuse it because they have Medicaid/Medicare through SSI/SSDI), etc. In order for the system to work properly it has to be based on each individual situation. You can't take a group of people from different areas with different disabilities and lump them together as one situation. That just does not work! My problem is...where do you even begin changing such a flawed system? I have no clue!

I have tried to contact my state representatives...that seems to do nothing (they were nice enough to give me the phone number for my drug company - Biogen, however, lol and tell me that they get these calls all the time). I even called a lawyer friend of the family that specializes in SSI/SSDI claims and was told that there is not much that can be done to change the system except to contact the state representatives, which I had already done. Talk about frustrating. How do you fight such a large system? I have been thinking about this a lot over the last couple of months (kind of in the back of my mind) because I feel like there should be something that can be done! I mean, if the state representatives office "gets lots of these types of phone calls" and even have the drug companies phone numbers on hand...that makes me think I am not the only one who is frustrated with the system. I am not the only one who has worked, paid in taxes, become disabled, only to be thrown into a system that doesn't care enough to want me to be able to maintain my health or support my family....after I worked to pay into that very system. So...I have been thinking....how did the people come together to fight and get the Family Medical Leave Act of 1993 created? That is what we need to do! That happened out of Washington State (where I live) you know. Somehow I need to find others, and we need to come together and fight this! I just need to figure out how to go about doing that...and the reality is, it won't fix my current situation. I will probably have used up my full 2 year wait period and will already be on Medicare by time we could get anything accomplished (if we were to even get it done) but if we could get it done...just think how many other hard working MS'ers who are currently paying taxes that may one day have to go on SSDI it could benefit! Not to mention all the others with other disabilities. That would be a great thing!


This concludes the 42nd edition of the Carnival.

The next Carnival of MS Bloggers will be hosted here on August 27, 2009. Please remember to submit a post (via email) from your blog of which you are particularly proud, or which you simply want to share, by noon on Tuesday, August 25, 2009.

Thank you.
Comments for this post.

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