Thursday, July 03, 2014


In my adult life I've only had health insurance for three years. I usually worked in small restaurants. Places that could barely keep up with my pay check and the owners didn't have insurance either. I had really great insurance for two of the three years I worked at EA and COBRA for a year after I was laid off.
Oregon has always had a health plan for low income people but it was hard to get into until the Medicaid expansion. Thank you President Obama. And yes I know single payer would be better.
There is also a  really great low income clinic in town so I went for my first insured check up a month or so ago. I am always nervous meeting new doctors. I loved my doctor in SF. And now, I love my doctor in Hood River. She is wonderful!
For the last few years I've been on a low dose blood pressure medication but I'd run out in January. It turns out my blood pressure is "great." She didn't want to put me back on pills. Works for me. I think there are a few reasons for this but I'm blaming Benedict. Pets lower blood pressure and fish are the best at it. My cholesterol numbers have always been good. My blood sugar hovers beneath the defined threshold for diabetes but doesn't change from year to year. That's been true for as long as I remember. So the numbers are good.
She referred me to an orthopedist to see if I could get knee surgery. They did x-rays. I have no cartilage in my right knee and I have a few bone spurs. My left knee is in better shape but not much better. I am the perfect candidate for knee replacement. Cool. Oh but they can't do it in Hood River because it's a small town hospital and not equipped. Huh? Not equipped for what? Because I'm fat I might have un-diagnosed heart disease and if my heart went crazy during surgery there would be no heart doctor available.
Hmmm. Let's review. My blood pressure has gone down. My cholesterol has always been good. My sugar numbers are not too bad for someone with a genetic predisposition for diabetes. I may well have un-diagnosed heart disease. I have a drug history. I have a tobacco history. It's been decades since I did either but still. There is heart disease in my paternal blood line. But...apparently those aren't the concerns. It's about my weight. If I lost a certain amount of weight I could get the surgery. She said a number. I didn't retain it. She is doing some research into hospitals in Portland that are "equipped" but she suspects either they or the insurance will require me to lose weight and possibly do lap band surgery first.
Lap. Band. Surgery.
That's not going to happen.
She gave me a cortisone shot. I can get three a year. I'm not pain free but it did make a difference. I spent my first day of less pain cleaning my bathroom without having to stop and rest my knee every two minutes. It was great! I'm not sure how long it will last. Let's say a month. Three shots a year. Three months a year of less pain.
So, I don't know what's going to happen with the possible Portland thing. Transportation is always an issue. Even the day of my appointment there were transportation problems and that's just in town.
It took me two days of brooding to be able to talk out loud about it. I'm hurt. I'm angry.
Unrelated to this experience I've thought about if I even could loose weight. I can say with absolute confidence that I have a very healthy diet. There are things I could eliminate but not much. My ageing slowed down digestion doesn't allow for much. I am getting to the pool now and will be getting there as often as possible. At the first check up I discovered that I had lost some weight in the last year. Not sure why but what ever.  
Here's the thing. I have a condition. I have pain and disability. Both can be mediated by technology. And I'm being told I can't have that technology because I'm fat. Everyone who has surgery is at risk for bad things to happen. I'm fairly sure everyone signs off on the possible risks before they lay down on a table and let a doctor cut them open. I imagine there may be people with a higher heart disease risk that get the surgery.
I feel like I need to make someone understand. Just listen to me. But I know there are people who get it and people who never will.
And now I'm going to go clean my kitchen while the pain is at bay.