Catastrophe is generally unplanned

In innocently mentioning to a friend, who is a Physical Therapist, the prognosis of a foot thing I have been dealing with, she said to me “Lesley, do you really want to know why you can’t get a diagnosis on your foot”  Well, of course I do so I said, “Yes”.  She told me it is because they have to treat all the Medicaid and Medicare patients for about $17.00 a visit. (that is the PT reimbursement I don’t know what the physician visit is)  That in order to make enough money as a provider, they have to treat more patients, often overlapping visits, and doctors and therapists don’t have the time to sit with you to determine the full diagnosis of intermittent and transient symptoms.  I said, “My visits cost me a $75 copay as well as the $200.00 the insurance company paid.”  She became adamant and said, it was because of the Medicaid patients that I had to pay so much.  We were at a party, I didn’t want to go into this any farther and quite frankly, I had to think about this and unpack both her anger and the facts. 

Cost of Reimbursement

I didn’t ask her what her solutions would be so my conjecture shouldn’t be connected to her.  Maybe she didn’t have a solution, maybe she was just frustrated with the increasing work load and changing regulations.  From what little research I did, I found the coding and regulations changed the end of the year and she is right the reimbursement is incredibly low.

I did two physical therapy visits at the previously mentioned charges ($275).  The first visit I was with the Therapist about 20 minutes and she did some strength and movement assessments, sent me some exercises by email and gave me an elastic exercise band.  The next appointment I went to the main exercise room which looked like a small gym.  I was instructed to warm up on the exercise bike for a few minutes while she finished her previous patient.  Then we went through some calf stretches, leg lifts, hip flexor machine, a foot rotating board which she asked me to do while she attended to a new patient who came in. She got him started on the bike.  When she came back to me, I was pretty frustrated because due to my “issue” I couldn’t do the foot board which she said something to the effect “oh, just do this…..”

”well, I can’t, that is why I am here…duh”.

 I left frustrated and of course, $75.00 poorer. (which they made me pay up front…smart)  None of that visit was satisfactory in any way.  I didn’t go back.  I joined a gym.  So I have digressed here somewhat. (Plus I will fully admit that I am sort of a nightmare patient… impatient and skeptical and a bit of a know-it-all)

I could see that the PT’s where having to balance several patients.  Some patients with far more serious issues were getting more attention and that was as it should have been.  I don’t know if they got reimbursed more for higher need patients but from the looks of most of the people in there…I was definitely paying the most and not a Medicare or Medicaid patient.  I don’t know why we have made the reimbursements so low, this shouldn’t be acceptable.  We, as the American public shouldn’t want that for our providers. 

I mean seriously, if you worked 8 hours and saw 16 patients you might bring in $272 for the day.  That is not enough to keep the lights on.  You definitely need me the insurance customer because you made the same on me as you did the entire caseload for the day!  Actually, I don’t know what the patient load for the PTs is, it could be even more.

I remember before the ACA a doctor said to me that we were already rationing health care by cost.  If you didn’t have the money and or insurance you were simply not getting care until it was an emergency.  I don’t think we want to get back to that because that isn’t ultimately cost effective.  But on the other hand we can’t expect doctors and therapists to work in areas with low reimbursement due to poverty when they barely can cover their costs:  building, staff, equipment, malpractice insurance and other health insurance for themselves and staff, and probably for time, college loans. 

So here is probably the “not” news;  Our insurance premiums are related to the low reimbursement of Medicare and Medicaid because those doctor fees the insurance companies are paying are necessary to offset the losses they are incurring due to the government squeeze. 

We need to cover everyone equally

I believe that my friend is compassionate and she wants people to have care if they need it.  However, not at great cost to her.

That is the $64,000 question; “What is great cost to each of us and how do we compute that?” I will just say that I do not have the ability to tease that magic needle out of the haystack.  I am just going to list some things I know.

            We need affordable healthcare coverage in what form, I am not sure

            When a person does not have reasonably regular checkups, things get missed.

Things get missed for long enough they have a tendency to become big things which are more complicated and costly to take care of.

Shit happens.  Yes, to the young and healthy as well.  Catastrophe generally means unplanned. 

Unlike buying tires, healthcare is a universal need.  You can choose to own a car but not your body.  I mean, here is a dystopian novel concept:  People who are injured in auto accidents and uninsured will simply be taken to a holding center (for sanitary reasons) until they are either picked up by a family member or die.  If there are any unresolved costs to their care, we can just begin harvesting organs….you only need one kidney, one lung, or one eye.  A slight hyperbole there for sure but what the heck!

I think there has to be some universal rate system.  I believe they do that in other countries that even have private insurers.  This is a hard problem, one that takes great care and we can’t allow our partisan division get in the way.  It is one of humanity.  Heaven help us.  

Itchy

ITCHY

Sometimes reflection takes me down a rabbit hole that I did not foresee.  I find myself in that position now.  I was approached as an artist to help with a program at Goodwood Museum and Gardens that was obtaining, on loan, the works of Clementine Hunter.  As I stumbled through the conversation, attempting to sound a bit enthusiastic for them, I thought “Who the heck is that”.  Sometimes people assume that because you are an artist you know about all artists throughout history.  I will admit that my knowledge in that regard is pretty slack.  I agreed to help, a bit, still not really knowing who she was.  Of course, once home I researched her. 

Clementine was a black painter born in 1886.  Her parents where slaves at one time.  They were still employed as field hands doing the hard work for the plantation in Louisiana.  In the 1940’s she and her family moved to Melrose Plantation in Natchitoches Parish, where she lived and worked as a cook and domestic.  As you know, the plantation life, with no free labor, was waning and Melrose was failing.   Carmelite Garrett Henry of Melrose brought it back to life as an artist colony where writers and authors stayed.  They encouraged Clementine to paint by giving her paints and supplies.  Thus her career began.  Her work is simple, untrained, and childlike but its simplicity tells the story of her and her people of the fields and community. 

So now you and I know who she was.  The “why” was that Goodwood wanted to present her work as a contrast to the art procured by the Arrowsmith’s of Goodwood, mostly Mrs. Arrowsmith.  This would be art of the Grand Tour. You know when all the well healed traveled Europe to play and buy things.   Well a small problem was that there is a bit of a time gap here.  The Arrowsmith’s owned Goodwood from 1886 – 1911.  They did furnish the house with lovely European art and objects. However, Clementine didn’t start painting until the 1940’s. Sadly, I don’t know that much had changed from her experience as a domestic and the 50 years prior when the Arrowsmiths owned the house.

I didn’t think too heavily about this at the time.  I just filed that away thinking that the board of Goodwood had thought this through and this was their program and it seemed like a good idea. European art contrasting with untrained art of an ex-fieldhand; you know, the haves and the have nots.  You might begin to see the problem here as I lay this out. 

Now, we know that in Tallahassee, just as now, and just as in everywhere else, there was a thriving middle class black community and there was an extremely poor community. There were those still providing domestic and field help to the large manor homes of the area…yes, they were still called plantations.  But here is one of the little itches under my collar, Goodwood doesn’t call itself a Plantation now.  They don’t like to use that word.  Granted, when you look at its long life from the 1840’s to today, it has not operated as a Plantation for most of that time.  It became a grand home, a hub of political and social activity and entertainment. Unfortunately, there is little historical data of slavery at Goodwood or conditions that the help lived in.  That isn’t really surprising because really it wouldn’t have been of much concern to write of anything distasteful.    

But here is the thing, all through this group of events, they did not address the lives of the domestics or field hands.  They did have one program that talked about the religious practice of hush arbors which was a way for slaves to quietly practice their religion as a mix of Christian and African.

 So you have to ask yourself how did we get Clementine Hunter here?  One of the co-directors knew the major collector.  That is all fine and good, her work has value as the story of her time and experience.  However, Goodwood has not addressed that at all.  That is my problem.  She was an interesting lady, no doubt, but really what does it have to do with Goodwood?  It was a stretch.  As a newspaper person once asked me. “What does this have to do with Tallahassee?”.  Not really a darn thing if you aren’t going to talk about the poverty, the back breaking labor, the community churches, the ways of life of Clementine’s time that where similar to the people here in Tallahassee working in the Plantations, farms, and homes. 

I don’t know, I just don’t see much celebration in the wide chasm between the haves and the have nots.  It is sort of like when they have the big real estate open house and the million dollar homes have the most traffic because who doesn’t like to see how the other half lives.  Goodwood is a beautiful home and has lovely tended southern gardens.  It has some interesting architectural elements but, yes, it is how the other half lived.  Maybe, they should just stick with that.  Even a large majority of their supporters come from the “have” side of things.  That is not that unusual in that that is where the money and time often is to participate.  But it all feels classist and it clashes in my mind with trying to pull some of the white privilege out in the open.  I could be overthinking this, as I said, a rabbit hole, but it is itchy.

I will not lecture you, go ahead, have a tantrum, you might feel better.

For those 8 thousand still without power 6 days from Hermine, my heart is with you. I will not lecture you on not being grateful enough. This is frustrating, disappointing, inconvenient, scary, and maddening. I hear you roar and I roar with you. My Mother is one of you. I will not take away your right to grumble, complain, stomp your foot and generally grouse about the situation. You have a right to do that. I know that almost all of you are grateful that it was not worse, that your abode although powerless, is still intact.

You have had to throw out your food, or try and maintain enough ice to keep it going, or listen to the drone of the generator possibly not even yours. Maybe you are lucky enough to have a generator, you have had to make several trips by now to get more gas to keep it going. It is noisy! You are trying to keep your windows open to catch a breeze. Neighbors have been generous and sharing for the most part.

Yes, we have been fortunate that the weather has not turned horribly hot and more humid. We have not had daily thunderstorms that make living without air conditioning or even a fan unbearable. However, it is still September in Tallahassee and it gets hot. Your hot water in your hot water heater is now depleted. Fortunately we do have water in Tallahassee and that was not interrupted, unless of course you had a well, then you had even more problems. A cold shower is still a cold shower. It is no fun to get ready for school or work with out feeling clean and refreshed. We won't even mention that morning cup of coffee that gets most of us going. Yes, these are mostly not life threatening, they are indeed inconvenient. Who likes to be inconvenienced?

Some of us are not eternal optimists. We do not generally rise from our bed with a smile on our face and a song in our hearts. I had a roommate like that in college and it was maddening. Some of us need to shake off the night time fog and reorient. It won't help to lecture us on being happier. It doesn't help to say..."Look at me, I am happy and uncomplaining... you should be more like me." It is kind of like when you are in a big argument with your husband and he says..."Calm down". Nothing will rise my hackles more. Maybe he is right but that is not the time to say it. A friend of mine has a great saying.."You don't pick up the dog shit while it is still soft and warm"

There has been some crazy conspiracy stories and faulting of government here and there and that is always going to happen. I am not going get into that kind of crazy. I am just talking about the people that just want their power back on so that they can get on with their lives.

When we are all back in our cozy bungalows and we are safe and cool then we can reflect on what we could have done better as individuals to be more prepared. We can do that as a city as well. But hey, let some of us have a tantrum or two in the meantime.

I wore a new Shirt and where it lead me thinking.

I wore a new shirt.   It is a t-shirt that a friend had printed at one of those companies that does that for artists and then the artist makes a pittance when you order their shirt to support them.  I didn't wash it.  Anyway, I wore a new shirt while I was cleaning the duplex getting it ready for new tenants. I didn't have too much to do, but it is summer here in North Florida and it is hot.  The air-conditioning was set at 80.  I worked up a little "glow" as they say down here.
  
I noticed that I was a little itchy.  I just thought it was from the "glow"; no, really sweat.  I got home at around 5:00 pm.  I was really itchy.  I don't know why I didn't take that shirt off the minute I got home.  Maybe, I thought that if I cooled down, it would get better.  No.  It didn't.  It got worse. By the time I took the shirt off I was a big red, itchy mess.  That was on the 11th.  

Here we are on the 28th and I am still itchy.  Not as bad but now I am kind of scabby in places on my back.  Okay that is TMI.  I took Benadryl.  I have used Benadryl cream.  I have used Cortisone Cream.  They have all helped to some extent.  I am still itchy.  Not so bad that it wakes me up anymore but I don't want anything rubbing on me. 

I used to get incredible debilitating allergy attacks before I did the whole shot thing.  When my histamines get going they don't want the party to end....ever. It takes drugs to finally throw them down.  I guess my arsenal of over-the-counter meds is just not enough.  I am hoping to rectify that.  Because those babies are back and are like "Hey, you haven't let us out in a long time and we want to Par T!"

Now this situation has caused me to make some modifications in my everyday undergarments.  I have replaced the giant rubber-band of a brassiere for a camisole style t-shirt. You would think that it would be considerably warmer considering there is a full shirt that you are wearing under another shirt.  On the contrary, it is pretty comfy.  

Somehow in contemplating this change of attire I began to think about how did we end up with the clothing that we have.  I mean who decided that women need to defy gravity with their breasts.  Why do they have to be rigged up to our chins in an unmoveable cup with just the right amount of jiggle on the top....for the guys.  Not only that.  I mean now they have little "daisys" in the cup to make sure that the nipple doesn't show.  

I am not saying this in a judgemental way, but some guys have a bit of breast and nipple action going on and no one cares or even thinks it is indecent.   So where has this come from?  Men? Then we have the issue in France where there was the whole Burkini up roar.  First we show too much and now we show to little. I mean who is the "decider" here?  Men are not required to cover up their breasts or their nipples.  You know they look very similar....sometimes more than not. Okay, women use them to nurse their children but people get really hinky about that too.  So it is okay to see male's useless nipples but not a woman's nipples, whether they are in use or not.  A woman can wear a teeny weeny bikini and show her whole breast but not the areola or the nipple. Somehow the whole breast is okay...just not the nipple.  Lets not forget, we can see them in  National Geographic magazine if they are aboriginal nipples.  I guess they are different.  (why do you think those boys were hiding those magazines under the bed?!)

Then I started to think way outside of the circle and I thought isn't weird that we worry about seeing the nipple through the clothes so the bra companies have devised a little shield in the bra to prevent them from "poking" out too much.  Yet, women who have gone through breast augmentation due to cancer surgery pay extra to have a nipple so they still look like breasts. I mean, I get it.  No judgement what so ever.   Then they put on bras that make the nipples invisible.  We are conditioned.  We are so weird. 

Cursive, I'm old school

My daughter-in-law just got her first teaching job.  I am thrilled for her.  It has taken a couple of years to feel confident to take this step so I am really proud of her.  She will be teaching 4th grade writing, grammar and spelling.  She could probably teach me a couple of things.

One thing she won't be teaching is cursive.  She doesn't believe in it.  Her school has many language problems with migrant children and other non-native English speakers, they don't have time.  Cursive seems like a luxury.  I hate that.

Don't get me wrong.  I didn't like penmanship.  I was okay at it but I hated being graded whether my h's went all the way up or my t's were just below.  It all seemed pretty trivial.  However, since I was born in the dark ages, before computers.  We had to write all or our papers and they all had to be cursive.  We all got pretty decent at it; well, most of us.  Even today when I go to a meeting, jot something down, write a grocery list, or certainly write a card, it is in cursive.

I always felt that when I wrote my notes in class I remembered them clearly.  I could almost visualize them on the page.  Do you do that if you don't look at the keys as you are typing?  I don't know.  Studies show that college students that hand wrote their notes vs. typing retained the information more.  You could print your notes and that would still work.  However, cursive is faster.  Most people create a sort of personal hybrid of the two.  That is also because most people that are now adults did have cursive.  What if you never did?  

I forget that maybe my niece and nephews can't read that.  They will have to hand the card to Mom or Dad and have them read it.  Should I stop or just keep doing that and then they will at least learn to read it.  

I have a cookbook of handwritten recipe cards by my Nana.  I treasure that. I treasure that she took the time to handwrite each card out for me.  I know copying them from her own favorite family recipes.  That took time.  I will have her handwriting there forever.  I immediately know it is her writing, just as I know my Mom's or my Dad's.  I know my husbands.  It makes it special because it is unique to them.  I suppose their printing would be as well....but maybe not.  

So yes, I am old school.  I think we should teach our children cursive.  I don't want knuckles rapped with rulers or grades attached to formation. It just seems so sad to lose it 

Shopping, I like it but what size!

The other day I went shopping with my Mom and we found a few T-shirts that we liked.  I bought two because they were really on sale.  They were very soft and a simple stripe that I can wear everyday.  I don't know if I was momentarily hypnotized in the store or just stupid.  Now that I have washed them several times I have found that they seem tighter and the once soft fabric is pilling significantly. They are Polyester Rayon and Spandex. They are both the same size, medium.  Of course one feels slightly more snug than the other.  They are a bit snug in the arms.  It doesn't bother me too much but I don't have really big arms.  I admit they are bigger than when I was 20.  For purposes of perspective, I am 5'8 and no more than 155 lbs.  I consider myself pretty average.   So much for a good deal.

I am sitting here typing in a shirt I bought at Target the other day.  It is an extra large.  I originally bought it to sleep in but then decided it was fine to wear out.  I don't usually shop at Target but their t-shirts run pretty small or is tight the norm?
What is the deal with spandex and t-shirts, or just about everything these days?   Good lord, I don't know how we kept our clothes from stretching out to ridiculous sizes until spandex came along.  My favorite old jeans that have formed to my body are pre-spandex.  Now, we can't have jeans without it. Why is that?

I went shopping with a good friend in Chattanooga and she took me to my all time favorite store, JJill.  Why do I like it?  I like it because all the clothes look like they are fresh and clean.  They don't look like they took them out of an overpacked shipping container from China with all the beautiful creases and wrinkles...and off smell that comes from traveling over the ocean salt air and all.  (Which they did when we later went to Kohls where I couldn't buy a thing for that reason)  I am digressing.  What I wanted to say is that I found a cute shirt on the sale rack.  It was a size SP.  You know what that means, small petite! As I said earlier....5'8" 155.  Nope not small or petite.  They do cut their clothes large (vanity sizing).

A couple of weeks ago I was going to a beer tasting and I wanted to wear my logo shirt from the brewery.  I had purchased and XL.  You heard me.  These woman's cuts are so small.  You know, I am of the age, 60, where our middles are not as svelte as they once were.  Why the heck would I want my clothes to be so tight as to show the complete outline of my bra and the top of my pants!  This is a problem with every woman's logo style shirt I have tried.  I have a Bonnie Raitt shirt...won't wear it out, another micro brew shirt, same deal.  I could buy the men's or unisex shirt... I hate them.  The crew neck is too small, the sleeves are huge boxes that look ridiculous and the body has no shape.  They are made for men so they go straight up and down...  that works out for many women but they are tighter on top and on the bottom and huge in the middle.  They are not made for us!

For that matter...I don't know who clothing manufacturers are making clothes for anymore!  I was explaining sizes to my husband.  I explained that there is the Misses dept and the Woman's dept.  He was like...Whatttt????? "Okay so that means sizes 0-16 (18) is in Misses and anything above that is Woman's."  Then there is Juniors which sort of works the same way but they are odd numbers 0-11, or sometimes they do a double number such as 7/8 or 9/10.

ARRRRAGH!  Now you know why we have to try everything on, often in multiple sizes!

I have been struggling with glass for almost 8 years.  What I mean by that is that I have been having trouble finding my voice with it.  Glass is hard.  It doesn't want to easily be sculptural when you are working with it as a kiln casting material and not blowing. There is carving the castable piece, making a duplicate model of it, and then making a plaster mold.  Each of these steps is arduous and fraught with failure.  

Along with that trip up, a family tragedy squashed my mojo. 

Now there is a crazy level of environmental concern for the manufacture of glass.  It has effected both the manufacturer that I use, Bullseye Glass but also others such as Uroboros. Spectrum glass in Washington state, announced they were giving up the ghost.  Bullseye is soldiering on and doing everything in their power to abide by the demands of all the governmental entities.  This has cost them money and thus they must increase the cost of their glass by 12.5%.  All the while, most customers have no idea.
Living on the East coast, we are at a disadvantage as the cost of shipping the material to us is over 10%.  Living in a small town with very little sales outlets we must ship our work to galleries, again another 10% hit.  This for a material that is already one of the most expensive mediums out there.  
Maybe this is a bit of sour grapes but all of this together has led me to question my desire to continue with glass.
Then the gallery calls and wants more...what is a person to do.  ARRRRGH!
Left in a quandary.