Friday, April 11, 2014

Social Security, Part 2

The next step in obtaining my entitled Social Security benefits required a visit to a Social Security-approved Psychiatrist to ensure that I was mentally able to make decisions regarding my own medical care. If you remember from yesterday how much I do not want to be on our government's retirement welfare system, and if you know how little I tolerate stupidity, you will understand why I was not the best-behaved patient at this appointment.

The psychiatrist is a lady maybe 5-7 years older than me. She was wearing a suit and had perfectly coiffed hair and nails. I forget what I was wearing, but I did dress professionally. From the moment I walked in the room, her demeanor was condescending and 'I'm-smarter-than-you.' She was polite, but not friendly, and she immediately began her official questioning.

Background: As part of both my pediatric and my ER training, I had a lot of psychiatric exposure. I am fascinated by the true crazies in the world. The wilder the hallucinations, the more fun I have. Overdoses and suicidal patients are my ER norm. Angsty teenagers acting out after a fight with their boyfriends or moms were everyday occurrences. I sought them out. I enjoy them. I took care of them. I know the game. I know the routine. I know the questions to ask and the 'right' answers to those questions. I did not become a psychiatrist, because I am too ADD with a need for instant gratification. Overdoses? Give me the narcan and charcoal, and let's go pump a stomach. Chronic depression and eating disorders? Let me get you medically stable then pass you off for the next few weeks-months of therapy. Not that I don't know how to do that therapy...I just don't enjoy it. I like instant fixes with rapid results.

Now back to my appointment with the Social Security-appointed psychiatrist. We started out discussing my basic information: name, demographics, why-am-I-here-today, that kind of stuff. And then she moved into familiar territory. I swear, the woman could have been one of my residents. She quoted the textbook almost verbatim.

Psych: Why are you here today?
Me: Because the disability company and Social Security made me.
Psych: You don't want to be here?
Me: Not really (I'm still trying to be polite at this point, but my inherent snark is fighting for an excuse to come out).
Psych: What do you do for a living?
Me: I'm a Pediatric ER doc. I work at _____, but I can't go back to work right now since I was diagnosed with MS.
Psych: Oh! You're a doctor, too?
Me: Yep. And I see a lot of psych patients in the ER.
Psych: Really? That's interesting...Did you graduate from high school?
Me: (I'm unable to hold the snark back any more) Seriously??? I just told you I'm a doctor like you. I actually have more training than you, because I actually did a fellowship, and you only did your residency, and you're asking if I graduated from high school?!!!
Psych: Yes. I am. Did you graduate from high school?
Me. Humpf. And I graduated Magna Cum Laude from Vanderbilt, too, before going to med school at BMS.
Psych: So you do have a high school diploma?
Me: (totally over this 'interview' by now) YES
Psych: Are you depressed? Do you want to hurt yourself? Have you thought about killing yourself?
Me: Nope.
***Insert Mini Mental Status Exam Here***
Me: (during Mini Mental) You do know that I know all these questions and that I can quote the questions and answers to you faster than you can ask them officially, right?
Psych: Why is that?
Me: Because I asked them every single day in my job in the ER. Pediatric ER doc, remember?
Psych: Oh yes. That is right. Continuing on. (And here she continues the Mini Mental, despite my telling her the questions and answers in advance. My patience for her was nonexistent at this point.)

When I got in the car with my husband to go home, he rolled his eyes at my lack of cooperation in the psychiatrist's office. He knows me and my lack of tolerance for stupidity, but he did remind me that she was responsible for determining if I was mentally competent enough to qualify for Social Security. When I reminded him of how much I did NOT want the benefits, he knew well enough to just let the subject drop. I think he was afraid I would take my snark out on him.

Sadly, a week or two later, I was fully approved for Social Security, and I've been receiving monthly checks since. I still hope and pray that I can return to work someday, but for now, this is our normal. God is good, and He continues to provide for my family each and every day...even if I don't like the method.

Thursday, April 10, 2014

Social Security: Part 1

Part of the whole long term disability applications requires conversations and meetings with Social Security. It's the insurance companies' rules. They don't want to pay out a lot of money, and a 35 year old physician on disability sets off every one of their alarms. If you are approved for their policies, then they require you to apply for Social Security. Now remember, at this point, I still intended to go back to work. I had zero intention of being on disability forever. God called me to Pediatrics, and that is where I want to be.

I avoided, stalled, and procrastinated dealing with Social Security as long as I could. I do not want to be on it. One day, Social Security called me. At home. And insisted I have a real conversation with them. I couldn't hide any more. Following is a replication of that conversation, as I remember it:

SS Lady: You do realize you are entitled to these benefits?
Me: I don't want them. I am 35 years old, and I plan to return to work someday. Older, sicker people need that money.
SS Lady: But you are entitled to that money.
Me: But I don't want it.
SS Lady: But you worked and saved that money. You are entitled to it.
Me: But I don't want it. I want to work. I do not want to live off of the government.
SS Lady: But it says here that you have 2 children. What about them? They are entitled to benefits, too.
Me: I am married. My husband has a good job with excellent benefits. I intend to go back to work when I am better. I don't need Social Security, and my children definitely do not need it.
SS Lady: But that might not always be the case. No one ever expects divorce, but your husband may one day decide to leave you, and then you won't have his benefits, and then you'll need this money that you are entitled to.
Me: Excuse me, but that is not going to happen, and even if something does happen to him in the future and if I do ever need this money, THEN I'll apply for it. Until then, I don't need it, and I don't want it.
SS Lady: But you and your children are entitled to these benefits.
Me: So you are telling me that despite the fact that there are people who actually need this government money to live that are being turned down for benefits, and despite the fact that I want them to get this money instead of me, I have no choice but to take it.
SS Lady: Yes. Because you are entitled to it, and they are not.

Wednesday, April 9, 2014

Disability 101

When I left my ER at 7AM December 26, 2009, I fully expected to return to work that night. When I was admitted to a neighboring hospital an hour later, I thought I would be returning to work after discharge. When I was discharged unable to walk without a walker, I knew I would have to file for FMLA (Family Medical Leave Act) and take a few weeks off to recover. I still fully intended to return to my job in the Pediatric ER, seeing patients and supervising medical students and residents. 6 weeks later I was still unable to walk past the stop sign at the end of our street, and it was then that I knew that my working life would have to change...but I STILL INTENDED TO GO BACK TO WORK.

I met with the hospital CEO to discuss how and when I could return. Per the American Disabilities Act (ADA), work places are required to make adjustments and allowances to help you do your job. My neurologist at BMS had already signed off on my state disability papers, because sadly, multiple sclerosis is a no-brainer. Our state sees the MS diagnosis and automatically approves applications. My hospital had been saying they were going paperless and to all-electronic charting for 3 years. It had never happened in the ER, even though the rest of the hospital had converted within the preceding 6 months. I asked that the ER make the change so that I could rest my hands and type instead of writing (At this time, even my signature was 'off.' My fine motor control was diminished, and typing/using the computer was a legitimate alternative to the writing we did so much of in the hospital (remember that CYA medicine discussion?)). The CEO refused. I asked to work part-time for a few months while I did rehab to regain my strength and endurance. She refused. I asked to work staggered shifts or to be the evening double coverage (which we were already paying outside docs extra to moonlight and cover the busier times). Again, she refused. She refused each and every ADA modification I requested. Her quote, "If you cannot meet the obligations spelled out in your contract, then your contract is null and void, and you will no longer be an employee of this hospital." Bottom line...major ADA violation.

Now I could have contacted an attorney and sued her and the hospital for ADA discrimination, but honestly, I just didn't have the emotional ability to fight that battle. I also knew that any money that I won, and any money that the hospital spent fighting me, would come at the detriment of the children that I have dedicated my life to caring for. Money at the hospital was tight, and I wanted our local kids to have more ICU beds and operating rooms and oxygen monitors than I wanted to fight a legal battle for my 'rights.'

So what did I do? First of all, I prayed. I had been praying throughout this whole ordeal, both alone and with my husband and family. I prayed a lot. I prayed for God's peace that passes all understanding. I prayed for our family's finances. I prayed for health. I cried out in frustration, knowing the Holy Spirit could interpret my cries. And God provided an answer...an answer that we thought, at the time, would be a temporary solution, but now, 4.5 years later, we are still living under. I applied for long term disability from the hospital. I cashed in a long term 'own occ' disability policy we had bought years before ('Own occ' basically says that if you are unable to continue in your chosen occupation, for me, specifically, Pediatric Emergency Medicine, then you'll be paid x percentage of your salary for life. Most insurance firms don't offer this anymore, and most people have never heard of it. Of those that have, most never bother to sign up, figuring they'll be a surgeon or anesthesiologist or family practitioner for life, because that's our calling, and that's what we spent so many years training to be.).

After several more months of paperwork and appointments, I was finally approved for both policies. My family was able to start digging out of the mountain of debt we had acquired trying to get through the previous months without my salary and with mega-hospital bills starting to come in. We are still working on that debt, but I know God will continue to provide. And God does have a sense of humor. I was and I believe I still am the ONLY physician to ever leave our hospital system on disability. I was 35 when I was diagnosed and went on disability, and by the time my hospital disability checks stop, the hospital will have paid me several times more than they would have if the CEO had just allowed me to continue working part time. My monthly checks from them are actually still higher than what my part time salary would have been. And that makes me smile. God wins every time.

Tuesday, April 8, 2014

I've Lost My Mojo

I am a scrapbooker. I am a photographer. I document life. These are my hobbies. They make me very happy. But sometimes I have to walk away from it all. I have weeks and months where I can't stay away from my desk, and I can't stop creating. And then I have weeks and months like I have had recently. I have lots of new toys to play with. I'm always taking pictures of something or other (just find me on Instagram if you need proof of that). I am surrounded by inspiration online and in magazines and catalogs...but I just don't have the desire to create. This has happened before, and I know it will happen again. It frustrates me, because I WANT to want to create, but I don't. I avoid going upstairs to my desk. I pile my new toys on the stairs. I find other ways to occupy my time (I mean, hello! Have you ever seen me blog this much EVER???) I immerse myself in life.

I may not be actively creating, but I am still always learning. The last 6 weeks or so have been rough...total life upheaval rough. Immune system shutting down. Pseudotumor cerebri. Changing MS medications again. Having to give up my very-favorite food cold-turkey. Major life changes. I tell myself it's ok not to be crafting and 'making pretty stuff' (as Heidi Swapp calls it). I am reading. I am researching. I am studying. I am pulling out my med school textbooks for the first time in years. I am learning how to transition my life and my family's life to this new reality. I am trying to relearn how to cook (Think about it...how many of your go-to recipes require flour? I had to relearn how to make a roux and gumbo this weekend! I can't even go to a deli and get a sandwich or soup any more, because they both contain wheat. This has not been easy or fun.).

So that's where I am. Not crafting. Not recording memories. Not playing with paper and glue. Not giving up. I am going to fight this disease. My doctors said I have to give up wheat and gluten. I may hate it, and I may complain about it to anyone who will listen, but I'm going to do it, because if it works, then just maybe I'll have a functional immune system again. I may have lost my crafty mojo, but it will come back...just as soon as I find a good substitute for hamburger buns so I can enjoy a good red meat fix again.

Monday, April 7, 2014

Not So Mysterious Ways

There's a common saying in this world that 'God works in mysterious ways.' I believe this is true, but I also believe there is a counter statement to this, as well: 'Satan works in not-so-mysterious ways.'

I've told y'all before that I was diagnosed with multiple sclerosis in 2009. Since then, my life and the lives of my family members have been unpredictable and sometimes frustrating. We cannot predict when I will have a Bad Day. We have, with time, recognized that if I am very active or if I 'push' for 2-3 days, then I will have to crash and rest for, at least, 2-3 days afterward. We try to schedule events accordingly, but part of the annoyance of MS is how you never know day-to-day how you will feel. I might do everything 'right,' and then still wake up the next day dizzy and unable to lift my head off the couch, much less walk around the house and do chores. My husband is amazing. He is patient. He is kind. He is the 'nice one' in our family. I am not. I am impatient. I get angry (mostly at myself and my body's inability to do everything I want it to do), and I get depressed.

How do I cope with the depression? For one thing, I have been on Happy Pills for years...even before the MS. My husband likes me on my Happy Pills. He likes not finding me in a closet surrounded by pictures sobbing because I used to laugh till my stomach hurt. I'm not a huge fan of the Happy Pills, but they do keep most of the badness away. I don't laugh as much as I used to, but I don't cry uncontrollably as much either. What I do do is sleep. A lot. And I read. A lot. And I scrapbook and play in my art journal. A lot. The severity of the dizziness and depression/frustration/anger often determines how much of any of these activities I participate in. I like being active. I like keeping my brain active. I like multi-tasking and doing 1000 things at once. I mean, seriously, I was an ER doctor. ADD multi-tasking was my life.

Which brings me back to my earlier statement: 'God works in mysterious ways, but Satan works in not-so-mysterious ways.' Why am I talking about this now? Because yesterday was a Sunday, and Sundays and Wednesdays have become my most-frequent Bad Days. If I could predict when a Bad Day is coming, I would have to bet on it being a Sunday or Wednesday. Why these days? Because they are important to me. I am a Christian. I believe Jesus is the Christ, the Son of God, who died on a cross 2000 years ago and was raised from the dead to save the world from our sins. Sundays are Sabbath days. We spend our Sunday mornings (and sometimes afternoons and evenings) at church, worshiping and praising God and fellowshipping with our church family. Wednesdays are also church days. We are Southern Baptists. Baptists still have Wednesday night church. Wednesdays are less formal than Sundays, and more time is spent digging into the Word and teaching it to our children. Wednesdays are when my husband leads the 1st-6th grade boys in Bible Study. Wednesdays are when our 7th grade daughter gets to praise and worship with the teenagers in our church and when our 2nd grade daughter gets to learn about missionaries and spreading the Gospel here and around the world. Wednesdays are when I get to be a Pediatrician again. Wednesday nights have become an unofficial clinic night for me. Rarely does a week go by that I am not called to see a child or 2 in the nursery for a rash or a fever. Wednesdays are my time to serve.

So why do I have many of my Bad Days on Sundays and Wednesdays? Because Satan wants to keep me (and my family) away from church. He wants to disrupt our friendships and commitments. He wants to attack our family directly. He wants to separate us from God. Satan knows that we belong to Jesus, but he does not want us to witness or serve or in any way further God's work. He wants to destroy our family. He wants to stop the spread of the Gospel of Jesus Christ. And so he is obvious in his attacks. He knows of my physical ailments. Why not stimulate the symptoms and accomplish 2 things at once? I feel awful, and I cannot attend church and worship and serve. But I've learned. This pattern has intensified over the last 4 years. I've learned that if I can raise my head off the couch and get dressed and make it into the church building, then I will not regret it. God fights for me. Who am I to stand in His way?



For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.
- Ephesians 6:12 (NIV)

Thursday, April 3, 2014

Tis the Season

As life goes on, we all have certain seasons we can count on. Yes, the whole world recognizes winter, spring, summer, and fall, but as homeschoolers, we have a few extra seasons. There's Back-to-School sales at our favorite stores (I mean, seriously, who doesn't get excited over 10cent boxes of crayons and notebooks? They make me happy.) There's the season when we are finishing our workbooks for the year. Such a feeling of accomplishment to see a completed math or spelling book. And then there's my very favorite season of all: Curriculum Buying Season.

For some reason unbeknownst to me, book companies have their curriculum sales in April. We are not talking a token 5% off your purchase sales...we are talking 20-30% off your entire order. Yes, it requires forethought. Yes, it requires planning ahead for next year and not waiting until July or August when I'll actually need those books. Yes, it requires budgeting ahead of time (or in my case, yelling towards my husband's office, 'I'm ordering curriculum now!' He's used to me and my spending quirks and blissfully-for-me, he keeps the budget ready for these moments). It works for us. I'm all about sales and saving money when I'm spending money, and if I can save $20-30 off my needed books, then I can spend that $20-30 on a film-making elective my oldest Kid is interested in taking. Right? Right.

Anyhow, today is my curriculum ordering day. Thanks to catalogs and the wonderful invention of the internet, I can do all my shopping from my couch. Much of my ordering is what I call 'refills:' a workbook or other consumable for my youngest to use with the main texts that her big sister used 4 years ago. I have tried very hard over the years to buy curriculum that would benefit them both. We are in this for the long haul. We have been homeschooling for 8 years, and I don't see that changing any time soon.

Interested in what we use? I order the bulk of our curriculum from www.christianbook.com and www.sonlight.com. They are both Christian companies that cover a broad spectrum of subjects.

Our current curriculum:
Math - Horizons (current 2nd grade LoveBug), Teaching Textbooks (current 7th grade Kid)
English - Bob Jones (LoveBug), Excellence in Literature Honors Level (Kid)
Spelling and Vocabulary - Horizons (LoveBug), Wordly Wise (Kid)
Science - Apologia - this year the LoveBug has done Astronomy and the Kid has done General Science
History and Reading - Sonlight (both)
Bible - no set curriculum, but they are encouraged to read their Bible daily and follow the Holy Spirit's guidance
Spanish - Rosetta Stone (both)

Wednesday, April 2, 2014

Finding Our Chosen Family

Do you have a Chosen Family? Do you know what a Chosen Family is? It's a term coined by my dear friend M to refer to our group of friends. According to M, your Real Family is the family you were born into. Your Chosen Family are the people God gives you to make up for your Real Family's faults. She says your Chosen Family includes the people you can truly count on. In this sense, I disagree. My Dad always taught me that the only people you can always count on are your Real Family members, and not your friends. He said friends would always let you down. I disagree with him, too. I believe that God has blessed us with a wonderful Real Family AND an amazing Chosen Family. I can count on them both, and I never knew that until I got sick.

2009 was not a good year for me. 2009 was when I was diagnosed with multiple sclerosis. When I walked out of my ER at the end of my shift at 7AM on December 26, I had no idea I would never practice medicine as an ER Pediatrician again. I fully expected to return to work 12 hours later to work another night shift. But God had other plans. I was admitted that day to a local hospital where I remained for a week. At discharge, I could barely walk with a walker around my house, much less drive or exercise. I don't remember much of the next 3 months. My mind has blissfully forgotten those months of lying on the couch unable to function...except for one significant day.

I will never forget it. I was lying on the couch doing my usual brand of multitasking - Internet, TV, and reading on my kindle - when some girls from our Sunday School class showed up at the door, girls I had only casually spoken to, but had never considered truly being friends with. M was with them. Their exact words, "Get dressed. We're going for toes (translation: pedicures), and you're coming with us." I tried to beg off, citing the constant dizziness that kept me from moving my head, much less my body. Their response, "Get dressed, or we're dragging you for toes in your jammies. You're going. You have no choice." I caved. It was easier then arguing.

I am so grateful that God sent those ladies to me that day. M and I talk and text multiple times a day, and it is a rare week that we are not trading off kids for some reason or another. She has become one of the best, most dependable friends I have ever had, and I thank God for her regularly. She and I are friends. Our husbands are friends. Our kids are friends. They're actually together so much, strangers think they're siblings from the way they act around each other. Our families are friends. They are our Chosen Family. And I am so very thankful.

Tuesday, April 1, 2014

Day to Day Change

Unfortunately for my family , this gluten-free lifestyle change affects them, too. We are a busy family. We homeschool. My husband works from home. We are always together - for better and for worse. To make sure our children do not become 'THOSE Homeschoolers' (you know the ones I mean - the cliché, grind your own grain, sew your own clothes, remove yourselves from society homeschoolers), we let them participate in several extracurricular activities. First and most importantly, we are active in our local church. Second, we are all active Girl Scouts (yes, even my husband). And third, we are active in sports, which I count as the Girls' PE. They average 1-2 hours of dance or softball 4-5 days per week.

This schedule does not allow for many home-cooked dinners around the table. We eat out a lot. Our main Family Meal is usually lunch, and dinner can be anything from a cup of cereal in the car to Moe's burritos or Chick-fil-a en route from ballet to Wednesday night services. It just depends on the day. All of this to say, not only has this gluten-free thing changed WHAT I can eat, it has also changed where and when we all eat.

So what are we doing? How are we handling this acute change? As best we can. I've given away most of my favorite baking mixes and go-to quick meals. I've stocked the pantry with just about every rice flour and potato flour and almond meal I can find, and I am slowly relearning how to cook. We are eating a lot more cereal for dinner, and my Girls are getting much better at fending for themselves. If I have a meeting or something else going on, my husband takes them to our favorite restaurants where I'm afraid I couldn't resist the yeasty goodness of the fresh baked bread. We are eating at home more. We are eating much later at night (you can still only do so much when everyone is gone from 4-7:30 every night). We are waiting for dance and ball to be over so that we can figure out a new schedule that works for all of us.

In the meantime, we are praying daily that this works and that my immune system decides to function and fight disease again. Because really? As much as I like bread, I like being not-sick and spending time with my family even more. Our God is a good God, and I truly believe He can do this for me. All I have to do is wait and hope. And if He decides to make me stay this way, I'll gripe and moan and complain for awhile, but then I'll suck it up and just deal.