Betty

Tuesday afternoon, I was sitting in my office when the phone rang. It was one of my former patients from the Diabetic Clinic.

She had been a patient here for at least 5 years – besides diabetes, she had an ovarian mass that we had been watching closely.

She and her husband both work; she works at a nursing home. Neither of their jobs offered insurance. Her husband suffered a heart attack last year, so they are paying hospital bills for that. She came in to see me in November to look at healthcare through the Marketplace. She picked a plan that fit into their budget with low monthly premiums, but a higher deductible. She was thrilled to have insurance that would start January 1, 2014.

So, when she called – my first thought was that she had found the high deductible to be more than they could afford. But, no – what she called to tell me was that she had been diagnosed with cancer. I assumed it was the ovarian mass, but was wrong again. She has been diagnosed with cancer of the esophagus, liver and lung. She is 55 years old.

I felt physically sick.

Glad that she has access to care; glad that she wanted me to know; a stark reminder that none of us knows what tomorrow brings.

Please keep her in your prayers.

Keith

I first introduced Keith on January 15, 2013 as one of my heroes.

Last week I worked in the pharmacy with him for the whole evening. One thing that never changes about Keith is that he loves to talk. So, while we worked, we talked.

When I last wrote about him, he had been diagnosed with Stage IV prostate cancer with bone metastasis. The prognosis at the time of diagnosis was 3 months with conventional therapy. Well, there is nothing conventional about Keith – so he chose experimental therapy.

September will be 3 years since he was diagnosed. It has been a tough journey for Keith and his family, but through it all, he has continued to work at his “real” job AND has continued to volunteer regularly at the clinic.

I am awed and amazed at that. There have been times when he was so exhausted he could hardly stand up; the only times he has missed his scheduled work days here are when he has an appointment at the University of Michigan on a Tuesday. Otherwise, he comes here.

He has always been one of my heroes, and during this time he has taught me – and others – about living, about faith, and about hope.

The Final Diabetic Clinic

“Sad.” “Relieved.” “Grateful.”

“It’s like a divorce you knew was coming, but didn’t want.”

Those were the words I heard from the patients in the Diabetic Clinic as we had our last-ever meeting. It was the last one because they all qualify for healthcare insurance. Two purchased healthcare insurance through the Marketplace; one qualifies for Medicare this month; the others all qualify for the Healthy Michigan Plan – Michigan’s Medicaid expansion program.

It was a bittersweet evening. We have been doing the Diabetic Clinic for around 10 years. It was the vision of Andi Scholl, PA-C. He wanted to try something different and new for diabetics – a clinic devoted to them done in a group setting. The patients all came in at 5 p.m. They had their vital signs (blood pressure, pulse and respirations) done, as well as their weight. Each one would talk to one of the nurses about what they needed that night – medication refills, to see the provider, test strips, etc. Then the group would meet together to share an educational program and a healthy snack.

When the provider came in, the ones that needed to be seen would have a chance to be seen individually. Each patient received a month’s worth of medications and glucose test strips to go with the meter the clinic provided.

The clinic was created by an amazing group of volunteers in addition to Andi. There was Pat Morgan, RN, and Sean Codier, a student at Hillsdale College who is now an MD with the U.S. Army and stationed in Korea.

Over the years, many others have volunteered their time and talents: Natalie Wyma, PA-C; Dr. Steigerwald; Dr. Schall; Linda Cosier, LPN; Marilyn Williams-Bayer, RN; Char Byers, RN; Mary Skupinski, RN; and, Cindy Horwath, RN. The pharmacist for the Diabetic Clinic has been Tim Skupinski, RPh.

I have some mixed feelings as this program comes to an end. It has been an amazing group of professionals to work with. The group of patients, for the most part, have been motivated, compliant and eager to take control of their lives. They have come each month to take part in the group. The names and faces have changed frequently over the years, but the support and care they gave one another stayed the same.

We will miss seeing them and they will, at least initially, miss seeing us. But, they are so much better off insured. They are a success story today – thanks to the Affordable Care Act.