FUCK YES

1/27/17     12:09pm

I am SOOO ANGRY. And I slept 22.5 hours last night so I have plenty of energy to direct that way. I managed at least to scream “FUCK YOU!” after hanging up the phone.

I called the Coordinated Care Initiative line for the State of California. They are supposed to handle the conversion to and exemption of dual eligibles (those of us eligible for both Medicare and MediCal) from the new managed care requirements in this lovely state. The only easy way out of this requirement is to have HIV/AIDS or be an American Indian. I’m tempted.

What am I talking about?

Medicare is the health insurance offered to most seniors and people on disability (after 2 years). It’s hard to find a specialist that takes it but there are many useful hospitals that take it for medical and psych. There is a 190 day inpatient limit for psych days at a free-standing hospital. (When I’m better I shall be tackling this.)

MediCal is California’s version of Medicaid (federal health program for poor people.) It is near impossible to find a skilled clinician, if they give you a doctor at all instead of an intern, on MediCal. It is a good net if you have non-specific or only emergency medical needs but if you have chronic medical conditions and/or psych needs and have only MediCal, you’re screwed. In some clinics it’s better to be completely uninsured and pay a sliding-scale amount and see a good doctor. Having MediCal (and Medicare for that matter) also usually exempt you from prescription discount programs offered by manufacturers, even though formularies are scant.

If you have both Medicare and MediCal, MediCal won’t pay for any fee that is above what Medicare determines they should be paying your clinician – no matter how far below industry standard or just human dignitiy would allow. Yet our great state of CA decided that being covered fully by both insurances was just too much. In Jan 2014 they started a “demonstration period” of what’s called the “Coordinated Care Initiative” and started forcing people into either CalMediConnect (a program that pushes you into an HMO that rolls your Medicare and MediCal into one, SIGNIFICANTLY limiting your benefits) or whatever Medicare you already have plus being forced into a MediCal Managed Care Plan HMO. I opted out of this “demonstration” in the very complicated and hard to find way they barely provided as I watched the change mess up countless lives.

Then a few weeks ago I got a similar packet in the mail. I did some research online finding that the demonstration period ended Jan 2017 but no info on what the outcome was, whether it saved money, links to the actions taken by our government to expand or make it permanent. Nothing. Someone from CCI called to enroll me in a plan Wednesday since I hadn’t mailed in the form. I explained that I had no intention of joining an HMO because it would complicate and jeopardize my care and she told me where to find an exemption form. But the form says it’s only for people who don’t have another insurance. So I called back today.

I won’t lie. I’d be happy if this man’s head exploded and a MediCal doctor was left to piece it back together. He tried to convince me I wasn’t being forced into an HMO. FALSE. Then he told me I’d qualify for a non-medical exemption but failed to mention the American Indian or HIV/AIDS part right away. I asked about the demonstration period and where I could find information. “We’re just the enrollment center. That’s the state… That’s not my department. That’s not my issue,” he said. He kept coming back to trying to tell me my doctors wouldn’t be affected by joining a Managed Care Plan. Then he went and said it. “Well, if the only reason your doctor won’t see you is because of the extra time it takes to do MediCal paperwork, is that really a doctor you want to be seeing?”

YES!!!

How much more of a fucking idiot could he be?!! Just how they want them at the CCI office I bet. I told him, “YES!” Those are the doctors who have time to hear what’s going on, who listen to my situation, who have experience and choose to actually get paid for it instead of working for free or just supervising 10 interns at a time as they run around the office “practicing” medicine. FUCK YES.

Aside from just being rich, Medi-Medi with fee-for-service MediCal was the best insurance one could get. MediCal pays my monthly Medicare premium, automatically qualifies me for Part D Extra Help (making my generic drugs about $1 and my brand name drugs about $3), and picks up the copay at any doctor I see or prevents them from charging me one. I’m not looking forward to this new world and what will be denied or changed. At least I can blame screaming “FUCK YOU” at them on being crazy.

TIP:
I run into doctors who take Medicare but not MediCal and if you tell them you have both they say they can’t see you as a patient because they don’t take MediCal and it’s considered fraud to charge me my Medicare 20% or anything else.
WRONG
Usually I just call back and don’t tell them I have MediCal. Then they take me but I guess it’s still fraud.
I learned this from HICAP when I called a few days ago: It’s not fraud if they give me a statement in writing that they don’t accept or bill MediCal and I agree to this in advance of treatment. Sweet! I’m on the search for a preformatted statement like this and will post it when I find it. Then I can blanket the city and my group with this new information. I even had a girl turned down by a Sharp Urgent Care the other day because they told her the same thing. I do have ins at Sharp…

Don’t fuck with a fucker. I’ll take you out. ;)

© Michelle Routhieaux 2017

God Breaths

1/24/2017

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There was a great image in this session of my mind filling my body as I breathe in and my body emptying it as I breathe out, purifying. Soleil called these Earth breaths. I think of them more as God breaths. The letters and lines represent disjointed thoughts.

© Michelle Routhieaux 2017

Hope in Electricity

1/23/2017     11:43pm

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I feel so good. My body is really sore and I can’t drive but I feel light. Colors are crisp and clear. They may only last a moment but I have ideas. I smile warmly for no reason. I breathe deeply without having to think.

Today I had ECT (my 1st since April). A change in anesthetic caused some problems but I am so much better. I am blessed with an amazing doctor who genuinely cares about me and a dream support team. Friends are helping with rides. I am released to rest and sleep (both from my depression & ECT).

It’s been almost a year since I was doing somewhat okay. My current therapist says he doesn’t recall ever seeing me not in crisis. Late summer I started to get worse. My repeated calls for help fell on ears that considered them my norm. I prepped to go inpatient in Sept/Oct but thanks to an amazing arsenal of coping skills and extra sessions of therapy I was able to hold off. I asked for ECT. My doc wanted DBT-IOP. I got pushed into a different program instead due to my people being in DBT, despite my multiple warnings that it was not a good idea. It was, as anticipated, a catastrophe that ended with an event appropriately described as trauma that I’ve yet to be able to process. In 1 day I went from 25+ hours of treatment/therapy per week to 2-3 hours. Not good.

Lately my suicidal ideation has been through the roof. I’m fighting for my life. I’ve also been impulsive, angry, self-harming, dark, unable to access empathy, scared, feeling alone and hopeless. Last week I called my therapist at midnight. I packed for the hospital. I cried.

They laid hands on and prayed for me at church on Sunday. It was unexpected yet utterly calming. I was surprised last week when my pdoc offered ECT. In one moment she validated and made my ongoing normalized experience true. I was confused. Even this morning I was panicked as they put me under. But Dr. M had my hand and I could feel God and see the outlines of my angel and D- and some unknown to my left. I am exhausted and sore but I am okay.

God, thank you for blessing me with family & friends and kick ass doctors. Please continue with my healing and keep using me for Your will.

My next treatment is Thursday. I wonder how long they will last – not the set but how long between treatments before the effect begins to wear off. I’m itching to do weekly. I can drive then. ;)

I enjoy resting and sleeping now. And rain

M

Update 1/31/17  1:46am:

I had a treatment on Thursday and another today. The weekend was really bad but I feel better now. I’m getting some rest and reminding myself to do one thing at a time, be “gentle to self,” as we say in group. I’m proud of me and grateful for my treatment team, my friends and ECT. There is hope in electricity.

© Michelle Routhieaux 2017

Have you Smiled yet?

1/14/2017     1:06am

Now that all the crazy end-of-year giving charity hype is over I have to ask, have you Smiled yet?

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I’m always looking for new and easy ways to raise money for my group DBSA San Diego. I love Amazon Smile. Here’s how it works:

  1. Charities can sign up with Amazon for an Amazon Smile account.
  2. People like you and me go to smile.amazon.com and sign into Amazon. If you have a direct link, you can choose that charity easily. If not, you can search from a list.
  3. Then just start your shopping from smile.amazon.com instead of plain old http://www.amazon.com. An easy way to remember is by just using the Amazon Smile extension for Chrome that you can find here. Sometimes there will be a pop-up to remind you if you’re on the regular site.
  4. When you buy things through Amazon Smile, your chosen charity gets 0.5% of the price.

To choose DBSA San Diego, use this link: https://smile.amazon.com/ch/46-4731973
The location says Chicago, IL because that’s where we’re headquartered.

Shopping through Amazon Smile doesn’t cost you anything extra. You only have to sign up once. All the same products are available. You just get to help out in a really great way. There’s even a little note by each product if it’s a purchase eligible for donation.

I’d appreciate everyone joining to support DBSA San Diego and sharing with friends.
Even if you don’t support my charity, it’s a really great program.

© Michelle Routhieaux 2017

Windows of Opportunity

12/5/2016     9:38pm

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I’m sitting in the VA parking lot. The potluck was tonight and I pulled it off well, got a special award from Libby. I cleaned up and socialized, kind of. I feel weak and dizzy and faint, like before I passed out yesterday. I walked the stairs anyway. I want that star.

(rest on my fist the space between my eyes)
Mom didn’t come.

I missed my opportunity. I fucked up. This is my fault. I need and wanted ECT. In the time I could have done it and recovered I tried something else to appease my doctor, which went horribly wrong. Now I’m in a med change. She’ll want to know if it’s working tomorrow.

Is my new med helping? Is it better or worse? I’m not sure how to answer that. Before I was severely depressed and non-functional. I wanted and needed ECT and had time to do it but needed help with logistics. Now I don’t know what I am. My best guess would be rapid cycling mixed episode with mild psychotic features and marked memory impairment. I go back and forth from bitter to rage to desperation to confusion – lots of confusion – and back. The period I’m not supposed to have now comes for about 3 days every week and a half. I’m bingeing a lot, making myself ill, impulsively maxing out my credit cards. I shut down completely in private and in public at inopportune times. I’m isolating from everyone, including D-. Fighting with Mom every day. Is that better or worse?

I missed the opportunity. They don’t come often. Today I went back to work for F-. I’m expected at group and outreach events and appointments. Because my moments are split I don’t get to pick ECT anymore. I don’t get to do what I know works for me ‘cuz I’m feeling now. Fuck.

(curled over, feel my heart beat on my skin)

I’m cold.
What do I do now?

Just keep working.

I didn’t matter enough to fix. :(
Not my turn.

3 – When Daddy hides the roller skates, run run away.
No like Daddy clip his fingernails.
Ice live in penguins, Mommy.

I get to see J- on Thursday. I don’t know how I’m going to pay for it but I want my life back. I NEED me back.

What do I want/need help with?

  • coaching through PRYT training – fundraising, planning, accommodations, follow-through, step by step
  • going through my stuff
  • fitting all I own into my room
  • conquering the garage
  • dancing again consistently
  • financial planning
  • losing weight
  • standardize & wrap up group business
  • have friends again
  • sing again
  • be in a musical again
  • scheduling – me + responsibilities
  • being around my mom with compassion

(stare, hear a GameBoy game song)

3 – I want to go humbly. I mean home. You bozo.

(VA police sweep)

The difference between now and then is that in the darkness I felt hope.

© Michelle Routhieaux 2016

Quiet is Purple

11/29/2016

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(sit quietly near to be where I’m not)

What seems like a void isn’t.
And what’s heard as silence isn’t.
The lack of air that fills my soul, it makes no sound.
No one hears the silent screaming.

Tea. Broadway. Fading lies.
No Giving Tuesday for me.
No Denver, or Ohio, or Scotty.

Quiet is purple.
Quiet is me.

© Michelle Routhieaux 2016

Fight Your Fight

11/23/16

election-2016I just signed one of the electoral college petitions online for Hillary. I don’t actually think it’s a good idea though. Somehow I’m aware that if we don’t give Donald Trump the chance to prove himself or fail, this divide will just grow and get uglier. Like when I tell a doctor I know their treatment choice is not a good option for me, sometimes I have to try it anyway to PROVE that I was right. I know it’s dangerous. I know I don’t like it. I always know it’s probably what we need to do. If my side is wrong and the country is magically better, GREAT! I don’t care who fixes it. I can admit I was wrong if the outcome is good. Being willing to suffer for the right to be right is a necessary cost that not all are willing to take. In fact, right now I’m dealing with the fallout of being right in my treatment. But I’m still right and now they believe.

Do I hate/despise/openly curse Donald Trump? Yes.
Do I feel hurt by the statements his supporters make about me? Yes.
Do his policies and promises and those of his people directly stand to ruin or end my life? Totally.
Do I understand why some of his followers follow him and believe? Yes.
Has any Trump supporter I’ve encountered mentioned stopping to consider how his presidency might affect me? Nope.
Did I vote though my vote doesn’t count? Yes.
Do I want to know what is happening in this presidency that will affect me and my loved ones for better or worse? Every damn thing.
Do I understand any of this? Nope. That’s probably a blessing.

Whatever side you’re on and for whatever reason, fight your fight. Just make sure you know what you’re fighting for and why. It really matters.

© Michelle Routhieaux 2016

Life Update – Thoughts from the Couch

11-20-16     11:46pm

I feel sad. (pause) I’m sitting on the couch, tv off. Mom’s asleep. The clock is ticking relentlessly, rain falling on the metal overhang outside. I watch the candle flicker. I don’t know what’s happening.

Today I went to church and lunch with my mom and her friend. I fell asleep after, picked up a migraine and forgot what I wanted to work on. I’m not doing well. I’ve been quite depressed for some time. I wanted to rejoin the ranks of ECT but tried an intensive outpatient program instead. That ended terribly. Now I’m trying to figure out what to do, only I don’t have the mind to do it. Dissociation has taken on a life of its own. I’m losing time. I can’t follow what’s happening. I’m sending freaked out emails to my therapist that later I have no or little recollection of. I started a new med that I’m pretty sure is either making my symptoms worse or holding off the small sanity breaks I usually get. I’m usually a shark when it comes to managing money and two months in a row now I’ve forgotten to pay bills. I can’t keep up with my work, often forget I’m even supposed to be doing it. I go to my group and do the bare bones. I’ve been somewhat honest about the fact that I’m struggling but I don’t share in group or when I’m willing there isn’t time. I avoid it altogether most times since the feedback I get is often silence or replies that are only vaguely relevant. My friends express concern and ask if there’s anything they can do to help. I know if I told them something they would do it, but I don’t know what that is. I’ve pulled away from almost everyone. I don’t know what to do. I go in and out of wanting to kill myself. It’s not a likely scenario considering I don’t actually want to be dead and I can’t undie if I don’t like it. Soleil also pointed out recently that I’m always moving and there’s no movement in death. That would certainly be a problem.

I think it was last month that I had packed a bag and left it in the car should I want or need to go inpatient. I’ve since unpacked it. I did tell my mom after a bit and I told her I was considering more ECT or an IOP. She didn’t really seem surprised or upset, or anything for that matter. When I went into IOP all that mattered to her was that I got my work done, which I didn’t. Ending the IOP was traumatic and I was upset for days. I couldn’t tell her what was happening and when I was finally going to she said something so offensive about a few of my friends that I wouldn’t. We got in a huge unrelated screaming fight a few nights ago. Today she said I wasn’t making sense. I’ll give her that. I tried very hard this evening to talk to her. I told her I’m losing time. I spent all my effort trying to explain what that means, what it’s like for me. (stare off into space) She picked up the remote and said, “What do you want to watch?” There was no response or discussion.

My therapist is doing his damndest, which I have to give him credit for. We’re in rough waters and even I don’t believe in me. For some reason he does. I feel horribly guilty for telling him the truth about what’s happening to me. I don’t want to be the girl who’s always in crisis. I mentioned something recently about working with and educating the police and he straight up laughed, said he would pay to see that, take the whole day off work. I don’t blame him. He’s never seen the side of me that can do that, just the one that’s freaking out.

I don’t know what there is to be scared of. I am so blessed. I live in a safe home with my mom who loves me. I have the most incredible team of providers I couldn’t even dream up and a steady source of income. On top of that, I have a God who loves and protects me no matter what I do and a group that’s got my back. I can let go but I’m afraid to lose control. I’m afraid of losing who I am.
Did who I am even matter?
Not really.
There you go.
I still feel confused and scared. God keeps telling me, “Go.” WHERE?!!
You’ll know.
Shut up.

I have to go to bed now. My goal is 12am and it’s 12:12am now. Thanks for listening to me vent. I hope you’re doing okay.

Michelle