Christmas Gratitude

Merry Christmas!

The end of the year is always a time for reflection and for gratitude. I want to take a moment of your time to thank my staff, the clinic volunteers, my family and friends for their support and encouragement over the past year.

To quote Charles Dickens – “it was the best of times, it was the worst of times…” and 2014 had plenty of both.

We began the year with the Open Enrollment in the Marketplace – and continued to attempt to enroll our patients. It was a frustrating endeavor at times, but when we successfully enrolled someone in an affordable healthcare plan, it was cause for celebration. Open enrollment lasted until the last day of March.

April 1 brought the best news to the population we serve –“opening day” for the Healthy Michigan Plan – Michigan’s Medicaid expansion. I will never forget the first person I helped with enrollment in the Healthy Michigan Plan – the tears in his eyes, and the words his friend spoke: “now you can get your heart fixed.”

The first four months of 2014 the clinic continued to be incredibly busy with an average of 64 patients every Tuesday night. That number began to decline steadily after April 1. We saw an average of 29 patients each week from April through December.

I have to thank Connie and Linda, and our volunteers, who worked in a time of great uncertainty. There were hopes and fears about what the role of the clinic would be – would there continue to be a need? Would there be funding? What would we do?

I am one of those people that love change – and embrace the challenge of something new. For many though the uncertainty is unsettling and difficult. But, everyone persevered and we continued to care for those in need in our community.

We spend hours trying to teach people about the value of insurance; assisting them with enrollment in healthcare; and helping with the transition to a primary care provider. It is some of the best work we have ever done!

We continue to see people in need here at the clinic.  The population of the clinic has changed over this year. Many of those we see are employed, making in the $8 -$14 per hour range. Their employer either doesn’t provide healthcare or they cannot afford it. They make too much to qualify for the Healthy Michigan Plan, and cannot afford the premiums of the Affordable Care Act, even with the tax subsidies. It is not my job to judge what is “affordable” for any family – I give them the information they need to make that decision.

And, with all of these changes at the clinic, I also had family issues to deal with. My husband was hospitalized for a week in May; my dad was diagnosed with bladder cancer – and died in September; my mother had a major heart attack in July.

It is amazing to have a staff that can pick up the pieces and make sure that the clinic can continue without missing a beat. Connie and Linda did that for me all spring/summer/ and into the fall. The support from the two of them, and the volunteers at the clinic helped me to survive all that this year had in store.

And, then there was the joy that came with the birth of my second grandson –Andrew James. The circle of life was so evident, as he was born 2 weeks before my dad died.

It is impossible for me to express my gratitude adequately. I am humbled and awed to work with such an amazing group of people. In addition to Connie and Linda, I have the most amazing board of directors, who support and encourage me always. The volunteers here at the clinic are the heart and soul of the clinic. We would not exist without them.

So, thank you to each and every one of you. Merry Christmas to you and your families.

And, I for one, can’t wait for the New Year!

Ted and Alice

Ted and Alice showed up one night at the clinic several years ago. I swear – they were both blue. OK, maybe more of a gray-blue. Clearly in respiratory distress. Clearly not doing well at all. They scared us, and we are pretty used to seeing all kinds of things.

He was a farmer and worked part-time in a retail store; she was a farmer’s wife. They had no health insurance. It was the dead of the winter, and they had run out of money – for food, for heat and for medications.

They both had a history of asthma/COPD but had not had any medications for a while. They both had acute bronchitis. I don’t usually believe that we have “saved” someone’s life, but in this case… maybe. If they had not showed up at the clinic, they would have eventually showed up at the emergency room – in worse shape than they were here.

They both recovered and were long-time patients here. They made enough money that they did not qualify for Medicaid, but his job was part-time so he was not entitled to any health insurance.

She ultimately was determined to be disabled due to her respiratory status – she was on oxygen full-time.

Ted was one of the original Diabetic Clinic patients. He was as compliant as he could be. He came to the clinic each month, took the medications we gave him, checked his blood sugar and tried. Dietary habits are hard to change for people on limited incomes. He continued to farm, so he was active.

As I think about the success of the Affordable Care Act, Ted and Alice come to mind. We supported them while there was nothing else available, but now they have access to healthcare whenever they need it. They have both found a primary care provider that they like. Plus, Ted has had some of the preventive healthcare services that are not available to the uninsured.

Today, I can smile knowing that they are in a much better situation – and we helped them on the journey there.

The Importance of Stories

Richard Rohr writes: “I’ve never known anyone who really shared all of their story with me whom I could not love.”

It is so true – we make assumptions about people when we meet them or observe them a setting. It is easy to dislike or distrust someone who is not known. But, once you sit down with a person and hear their story, it changes everything.

I had that experience last week. A former patient called, wanting an appointment to review his health insurance coverage. He had been paying his premium for a year, had used his health insurance appropriately, and wanted to review it. A total success story! Except for the fact that when I heard his name, I just shuddered.

We ran into a few roadblocks during the process of reviewing his insurance coverage, so we had some time to talk. I had made some judgments about him. What I learned in the time we spent together was a completely different person than I had assumed.

His mother died when he was 8 years old. It had clearly impacted his entire life – including the fact that he was not able to finish school. He wasn’t “stupid,” he was uneducated.

He is married to a woman who lost five children in an intentionally set fire decades ago. She is broken – emotionally, physically, and mentally. His concern and love for her was evident.

Because of the time we spent together, my attitude toward him changed dramatically.

I see this so often with the population we see here at the clinic. It is so easy to make assumptions. I often hear someone say, “he’s just a user.” But sometimes that “user” is taking care of an elderly mother with dementia, or is the only parent to a young child, or is recovering from substance abuse. We never know the battles people are fighting in their lives.

We really need to take the time to hear their stories. 

Holy Batman!

Well, that was a first. We had to delay the opening of the clinic tonight… because we had a bat.

Oh, it’s not the first time we have had a bat – the clinic is located in the basement of a church, and bats seem to like churches. They are frequent visitors here. And we have even had them during the clinic, but we have never had to delay opening the clinic.

My feelings about bats vary on a scale between grossed out and terrified – depending on how close the bat is to me. I loathe them – especially when they are indoors. (Shudder!!)

Fortunately, we had a couple of volunteers that were eager to escort the bat out. If it happens when I am here alone, I have “Batman” on speed dial. Batman is my hero Patrick who serves as the sexton for our church and the Catholic Church next door. I’m guessing he has lost count of how many bats he has rescued me from!

Monica

As she walked into the clinic, my eyes about popped out of my head. She was beautiful – looked absolutely fabulous.

When I first met Monica, that is not how I would have described her at all.

I had known Monica’s mother for a few years. She called me one day very concerned about Monica and wanted to know if we could see her here at the clinic. They both came in on Tuesday evening. Monica was 21 years old at the time. She presented with fever, nausea, vomiting, weight loss, headache, aches and fatigue. She was dressed in jeans and a baggy sweatshirt. She was pale and clearly did not feel good.

We ordered some tests and put her on some medication for the nausea and vomiting. She returned two weeks later for test results, still not feeling any better.

At that point, I helped her with her application for the Healthy Michigan Plan. She was working in a low-paying job. She qualified immediately for the Healthy Michigan Plan, and was able to see a provider in our community. I lost track of her after that.

She came into the clinic to bring some paperwork. I hadn’t seen her in six months – and could not believe it was the same young woman. Because of having health insurance, she was able to get the care she needed. She still has some problems, but they are minor compared to what she was dealing with a few months ago.

She is in school, motivated to live her life to the fullest.

The outcome could have been very different – without a parent who cared and without access to healthcare.

It’s Flu Season

Everyone was in a panic about Ebola a few weeks ago, but how many of you have had your flu shot? It is the easiest way to prevent a disease that causes illness, loss of productivity and too often, death.

The timing of the flu season is unpredictable and varies from year to year. Most commonly it peaks between December and February. But, it can occur as early as October and as late as May.

Contrary to popular belief, the flu is actually a respiratory disease, not a gastrointestinal disease! The flu can cause vomiting and diarrhea, more commonly in children.

Flu symptoms include:

• A 100^oF or higher fever or feeling feverish (not everyone with the flu has a fever)
• A cough and/or sore throat
• A runny or stuffy nose
• Headaches and/or body aches
• Chills
• Fatigue

In general, the flu is worse than the common cold. Symptoms such as fever, body aches, tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose.

Seek medical attention immediately if you experience any of the following:

• Difficulty breathing or shortness of breath
• Purple or blue discoloration of the lips
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Seizures
• Flu-like symptoms that improve but then return with fever and worse cough

The flu is most dangerous for infants, the elderly, and those with chronic health conditions such as diabetes, asthma, COPD, and cancer.

So please, get your flu shot!

Buzz

I wanted to take an opportunity to say goodbye to a dear man.

I met Buzz and his wife several years ago. The clinic was fairly new and one of the local food pantries called asking for some flyers so that they could let their clients know about it.

I put a handful of flyers in an envelope, but then decided it would cost too much to mail it. So, I got in my car and drove over to the food pantry to deliver them.

Buzz and his wife were volunteering at the food pantry when I got there. We just hit it off right away. They were so excited about our new ministry and were so aware of the need in our community.

I have always called this meeting a “God moment.” It was meant to be.

Buzz was very active in the community – he arranged for me to speak a couple of times at a service club where he was a member. He and his wife sent the clinic a check every single month.

Buzz died a couple of weeks ago. He will be missed by us here at the clinic, by his community and all of those who knew him.

Our sympathy to his wife and family. Buzz made a real difference in this world.