September 26, 2013

Three Circuses Worth Of Crazy

Picking up where I left off last time, there's still chaos in my world.  But, it seems like it's at least coalescing into the familiar and typical kind that surrounds me like a dyson sphere.  If we were in a movie, the screen would dissolve into a flashback where you'd see me moping around in a muu-muu, knowing something was wrong in my head, but not having whatever it took to do anything about it.  Everything in front of me looked like Everest, and my sherpa is 90, asthmatic, and I've got to carry his gear.  This is why.  I'm employed.  Heck, I'm doing quite well for myself.  I've got insurance, so I'm not going to lose all my pennies should I get hit by a bus.  I'm doing ok.  Until I have to do more than live paycheck to paycheck.  Which, I've had some emergencies, hastily planned big expenses, and some genuinely splurgey moments in the last 2 years.  My savings are not fat.  My medical flexpay account is depleted, and has been since July.  And here I am headed up the incline of euthanasia mountain in my mental theme park of horrors.  I’m not quite working poor, but I’m certainly working on eggshells.  
When my episodes of my flavor of crazy gets to be a little more than I can handle with the medication I'm on at the time, all it usually takes is a couple of visits to the doctor and maybe a tweak to the dosage.  Problem is, each time I walk into the office to talk to a doc it costs me roughly $150.  I could swing that every couple of months, but not every few weeks.  Not to mention I don't know what any new medications will cost.  I'm lucky that Zoloft works for me because it has a generic I can get for $7 a month.  So, I'm crazy on  budget.  Woo.

Making changes is a herculean task, even for someone who's not feeling like they're dragging every ball and chain ever shackled to a slave behind them.  I gotta find a way to get the time off, to afford the doctor, wait to get the appointment, wait to get the new med/dose, wait till the doctor's office hashes out the new medication with  my insurance company, wait to get the script filled, and finally, wait for the medication to work.  And it's not guaranteed to either.  It's a trial and error thing.  Not every medication works for every person.  You try one, wait at least 3 weeks, and maybe you try again.  Lather.  Rinse.  Repeat.  And that's if everything goes as expected.
Eventually, I swallowed my pride and decided to call around to see if there were any sliding scale options for people in my situation.  My first call was to 211.  They're a hotline run by United Way.  I asked them if they had any low cost programs options for mental health care for people in my situation.  I got a couple of suggestions to start with, which was good.  A few weeks later, I also walked into the Employee Assistance Program office at work asking similar questions.  I wanted to know if I had other options.  Armed with a list about three names longer, I went home and. . . I sat.  And I stared at the phone.  And I thought about it.  But, it took me about three more weeks to pick up the phone.  I took a day off of work for a mental health day, and so I could get some odd jobs that had been stacking up done.  At about 2:00 in the afternoon, I won the Mexican standoff with my phone and called the first name on my list.  Lutheran services had psychiatric services, but since I had insurance I *had* to use it.  They’re state funded and apparently that’s part of their charter.  Thing is though, my insurance is part of the problem.  No copay means  I’m out the negotiated amount for the visit.  That adds up quickly.  The second place, Catholic Charities, had counseling, but not psychiatric care.  Meaning, I could talk all I wanted, but I wasn't going to solve the medication problem with them.
My energy dwindling, and wanting only to give up and go lay in the dark of my bedroom, I picked up the phone to call one more place on my list.  The Charles Drew Health Center is a full service health provider for low income adults, children, and families, located in North Omaha.  They are also government funded, though I’m not sure if they’re entirely funded, or just subsidized.  I was able to speak with someone in their appointments area about whether or not I would even qualify for their services.  I figured that just based on what I make an hour, I’d make too much.  I clung to the hope they’d take into account the fact that I have almost a third of my income garnished each month.  The final say on this ended up being bittersweet.  I can still use their services and their sliding scale fee system, but they base where I fall on the gross of my income, not the net.  So, it’s a partial win, and one that lets me feel less guilty.
Where does the guilt come from, you ask?  You know how I’ve said the notion of my being too good for someone is lost on me?  Yeah, that doesn’t work for “things”.  I feel like I have my shit together enough to get this far, why should I not suffer to afford non-subsidized care?  Why do I deserve the breaks when someone else might benefit from them more?  And yet, the rational voice in my head, tired and bored as it is, yanks on the emotional side’s leash and reminds it that this is what it’s here for.  It’s for people who are under strain, financial or otherwise.  I just had to choke on that chunk of pride and realized I am good enough to get well, and use any service available.

So, I made an appointment for 8:00 on a later Friday.  I was asked to bring a few things; a picture id, my social security card, a copy of my paycheck, and a bill with my address on it.  I got those all gathered up and put in a safe place so I’d remember them the day of the appointment.  Amazingly, I actually did remember them, and showed up bright and early for my meeting.  The place was barely open, and I began to wonder if I had misheard the person about the time.  And, I had completely spaced off her name.  But, I had my papers!  I could prove who I was, dammit!  
When the registration window opened and went to check in, they asked me who I was there to see.  Since I didn’t remember her name, I just told them I had an 8:00 with a very nice lady who I had understood to be a counselor for mental health.  That’s when they looked at me like I sprouted a second head.  You see, none of their counselors came in until 9:00.  So, it looked like I had an hour wait ahead of me.  Thankfully, I had just loaded a new book on my phone and had something to do.

When I finally sat down with Cindy (not her real name) she was very apologetic.  I told her not to worry about it.  shit happens, and at least we got to it, even if it wasn’t at the time I had expected.  I had the whole day, after all.  We talked a bit about why I was there and what was going on.  She agreed that it was a good idea to talk to a professional, if even for a mental tune up.  She also said that they could provide an MD who would work with her to help get my medications adjusted and hopefully control my depression and anxiety so that I could get back to living instead of merely existing.  (For those of you who have seen me out and about in the last 6 months and see me happy and bubbly, that’s not fake.  But, it’s not an energy level I can maintain for long.  When I’m out of gas, I tend to crave solitude and very low activity levels.  And I’m out of gas alot sooner and alot faster than I’m happy with.)  The appointment ended with my giving her all the paperwork she’d asked me to bring, setting up another appointment with her and one with the doctor, and feeling like this was the first day of the rest of my healthy life.  (Or some other inspirational nonsense that’s meant to be uplifting.)  No, I really did leave feeling like I was on the right track, and I looked forward to putting a collar on my brain and making it my bitch.

A few days before the next appointment, I got a message while I was at work that Cindy had a conflict and couldn’t make our appointment, but to call her at this number and we could reschedule. Well, I did call her, but the phone system was so convoluted I never did get through to her.  I figured I’d reschedule the day of my other appointment with the doctor.  Here’s the thing though.  The day of the appointment arrived, and I can’t pry myself out of bed.  Not just the house, my bed.  I was awake, and mentally kicking the shit out of myself trying to get me to even put one foot on the floor.  Nope.  Didn’t happen.  I stayed in bed until the very last moment before I had to start getting ready to go to work.  And even then, I drug myself around the apartment, my knuckles figuratively dragging across the floor.  
Two weeks later, I had stored up enough oomph to call them back and try to reschedule.  So, I did.  I ended up leaving a message, asking for a call back so I could make an appointment.  Three days later, I get a call from a lady with the center asking me if I missed my original appointment.  I fessed up, and said I’d like to reschedule.  I asked if this was in response to my message I’d left, and she didn’t have any idea what I was talking about.  But, she did offer to get me to the scheduling department.  And after the transfer failed, and the call being disconnected twice, I finally got a chance to talk to someone with an appointment book in front of them.
I thought I hit the jackpot too.  I was able to see both Cindy and the doc back to back just two days from then.  One at 8:00 and one at 9:00.  Sold!  I swapped shifts with a coworker so I didn’t have to use sick time, and life was good.  This is where I should have listened to my spidey senses.  Remember the original scheduling problem?  Yeah, it’s the same one the second time too.  I get to my appointment and they’ve got me down for a 9:00 and a 10:15.  Not only will I be waiting another hour, I’ll also be late for work.  Fuck.  My manager and my boss have been wonderful when it comes to taking my chaotic life in stride, but if I didn’t have to put them in that position, I didn’t want to.  The short version of a very long story is that I was sitting in the lobby, trying to get a signal for my phone so I could call my manager and give her a heads up about my maybe being late when Cindy walked in, a full 50 minutes early to work.  She saw me and said hello.  I gave her the short version of my morning, and she offered to go right in, get logged on to her computer, and start my session right away.  That way, we might be able to sneak me in for a quick visit with the doctor before his 9:00 patient came in.  What followed was an absolute fustercluck, but we got it all done.  I got weighed, measured, assessed, and filed in one totally disorganized whirlwind.  My paperwork that I had brought for the original meeting had been lost, so we had to start over.  Thankfully, I could log in to work and get my paycheck stub online, I had my id, social security card, and my car’s registration with me, so we could reproduce what was lost.  But what a hassle!  
I got a good half hour or so to chat it out with Cindy before our session was over.  Afterwards, I made another appointment to see the doc and dropped my prescription off at the on-site pharmacy.  That’s where I met my last challenge of the day.  They only had half of my prescribed dose of medication.  The rest would come in the following day, and I could come back and pick it up then.  They’d fill what they had now though, so I could start on it as soon as possible.  Not the worst hurdle of the day, or the entire process, but it was a bit like the piece of corn on top of the shit sundae.  
Sure, none of these bumps in the road are truly horrible.  They’re pretty easy to overcome, right?  Now, consider this.  You’re placing these obstacles in front of someone who gets nauseated to think about leaving the house on most days.  Someone who hasn’t had what it takes to even see the people who are most important to her in the last 6-9 months.  Someone who knows something is wrong, but can’t so much as pick up a phone without days worth of psyching herself up to do so.  Some people might call me a strong person.  That my refusal to let the potholes in life send me to the pit, even with a bent rim or two is above and beyond average..  Nah.  I’m not.  I’m just selfish, and too stubborn to know when I might be licked.

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