I: Insurance



With or without?

I have been on both sides of the coin (and I found out recently that I am abruptly without…but that is another story, fml).

And honestly, it is easier without.  I understand why people aren’t signing up for Obamacare.  Insurance is a pain in the ass.  Sometimes literally.  It can give you diarrhea.  See this post here.

My year without insurance…hmm..I probably didn’t get the BEST care possible.  But I received adequate treatment for my condition.  Steroids have been around forever.  They are cheap.  Methotrexate has been around forever.  It’s cheap.  At one point the doc wanted to try a RA med, but because I was uninsured, I couldn’t have access to it.  But it wasn’t life or death, and it didn’t make a difference in the outcome.

Now, I do owe something like $20,000 in medical bills.  I did have to come off some of my maintenance medication (such as Topamax for migraines) but there are ways to obtain expensive meds.  That paperwork sucks too, but again, it is possible.  I obtained my Lyrica and my migraine meds (Treximet) for free by sending in proof that had virtually no income and a script.

It helps that I’m a nurse.  I know what signs and symptoms are dangerous.  My docs trust me to monitor myself, my blood pressure, to titrate my meds on my own.  So that makes a difference.

Since I have had insurance (since Novemeber).  It has been a pain in the ass to get ANYTHING fucking covered.  Meds, doctors visits, procedures.  I have to prove everything. Prove that I have this.  Prove that I need that.  I have scanned countless receipts, doctors notes, etc into their “easy to use” data base to get shit paid for.  And now I don’t have insurance because the mother of my bonus son doesn’t have his birth certificate and we couldn’t get it from the state in time to make the deadline.

So instead of kicking him off the insurance (he has other coverage, we were just trying to get him BETTER coverage), they kicked us all off.  I went to get my meds the other day and was absolutely shocked at the cash price.  So now I’m paying by the pill until it gets straightened out.

So yes, insurance can be a lovely thing.  But it can also give as many migraines as it prevents.

It’s a full time job…


And no, not one that actually pays me.  I’m talking about trying to get my medical issues paid for even when I have insurance.

My husband has United Healthcare.  And I am thankful to finally have insurance, but the hoops I have to jump through to get anything paid for are absolute insanity.

He has an HRA, which I am slowly figuring out.  They basically put money aside from his company (not just the FSA, I’ll get to that in a second) to pay the deductible.  Half of the deductible.  No copays until the deductible is satisfied.  My deductible is $3,600.  But I’m halfway there on February 1st.

But trying to get the HRA to reimburse ME for out of pocket expenses is like pulling teeth.  I submitted one bill in the first week of January.  They said they lost it.  I submitted it again the following week, they said that they couldn’t read my name on it.  They actually told me to take a pen and go over the name and amount on the receipt so that they can see it better.  FML.

So I am trying to resubmit right now, have been for the past week, and it is either their site being down, or something wrong with the settings on my computer, because it won’t upload.  But I can upload things just fine to other sites, including ADP (that’s another headache).

I have even toyed around with the settings on both this computer and my own laptop.  Nothing will upload.  So I will go the fax route.  But they don’t understand that not everyone has a fax machine, and to get to one i.e. Kinkos or a mailbox place, entails a chronically ill person getting out of the house and physically making it to said fax machine. Fuck.

Now ADP.  I hate them.  With a passion.  I have used the brand new FSA card to try and pay for this shit.  And they promptly cut it off after the first transaction.  And they won’t just take a regular receipt.  It needs to be a “detailed” receipt.  But at least their site lets me upload.  It just takes forever to go through their system.  So maybe I’ll get access to the money my husband already has set aside for us to use in the near future.

And its not like I actually need this money or anything.  I just have thousands of dollars sitting around to pay these out of pocket expenses.

So I am patiently waiting for the mailman to get here with my husband’s paycheck so I don’t have to be relying on Sunshine’s cookie money to keep gas in the tank.

That’s another headache too.  My husband works for a multi-billion dollar international company.  He has been working his ass off since he got this job, on night shift no less.  He volunteers for overtime.  Yet he has had not one paycheck that wasn’t completely fucked up.  And it is not just him.  All of his friends have had issues with their pay for MONTHS.

He has been working there since the end of October.  He has submitted his forms for direct deposit FOUR TIMES.  FOUR FUCKING TIMES.  And yet it has not gone through.  He used his PTO to go to Delaware last month.  His first paycheck when he got back did not include his PTO.  That was fun.  Nothing like expecting a paycheck for a thousand dollars and getting one for $400.  There was also the time that they mailed him a paycheck, and then stopped payment on the check for no reason.  Right now, his company owes us like $300 in overdraft fees.

This last paycheck, they shorted not just his overtime, but his shift differential as well.  And the HR people at his company are complete assholes.  I mean the ones at his physical worksite, corporate is fantastic.  But these assholes act like they couldn’t be bothered to actually do their jobs.  They act like them not paying him is none of their concern.  And because they are only there from 8-5, and his shift is 6p-6a, he rarely has the opportunity to see them with his issues.  And no one will talk to me.

And I am still on the job hunt.  But I got some bad health news today, so that might be stalled.

I had a colonoscopy/endoscopy done on Monday. There is “inflammation” in my stomach and intestine, but they don’t know what is causing it.  I have to wait for the pathology report.

My pain has been just awful.  My joints are starting to swell and I can feel the warmth and see some of the redness.  So I saw the rheumatologist yesterday.  She is VERY concerned about the GI stuff.  She told me that just based on feeling my joints, they are inflamed and swollen.  So she got xrays of my hands again and drew 6 tubes of blood to see what is going on.

On the positive side, maybe this will clear up what is actually going on with me.  Maybe the biopsy from my gut can finally tell them if it is sarcoid or not.  Maybe my blood will come back positive for something else other than just an elevated lysozyme level.  Not that I’m hoping for another diagnosis, I just want a CLEAR diagnosis.  Something that says “yes, you have this disease, and this is how to treat it”.

Ugh.  Off to apply for more jobs.  That alone is another full time job.  “No, we won’t accept your resume, you have to list every single employer you have had for the past 10 years, their address, their phone numbers and your supervisors that probably aren’t there anymore”.  And given that people with chronic illness tend to change jobs or have holes in their employment history, this is a fun task.

I’m pretty sure I have lost out on three jobs right now because I answered truthfully when they asked “and why did you leave your last job?”  I said “because of acute illness”.  I specified “acute” because that is different from “chronic” and I already learned a long time ago to keep the fibro under wraps.  So now I’m going to start lying.  “Oh, I didn’t feel like working anymore” and keep this entire fiasco under wraps.  I just feel so wrong about it.  I don’t like concealing the truth, and if someone is going to invest time and money to train me, I don’t want to come to them a month later and say “I need to take some time off because I’m sick again”.

And these aren’t even full time jobs.  I’m specifically looking into PRN jobs.  In the  nursing world, that means “as needed”.  Most of these jobs ask for a set schedule, but you aren’t “forced” to work 12 hour shifts or weekends.  They usually don’t come with  benefits, but I don’t need them.  This was my plan BEFORE the autoimmune diagnosis.  To go PRN once my husband found a job with benefits.  Something flexible so that I can work more when I’m healthy and bow out when I’m not.  It’s not an issue of not wanting to work.  I have been sick long enough to know that I CANNOT work full time, unless it is something so benign and easy that I don’t move much.  Good luck finding that as a nurse.

So if anyone has any ideas on any of this, how to navigate this insurance nightmare, where I can work, give me a clue.  I’m very frustrated right now with this state of affairs, not to mention my living situation.  Sorry for the rant.  Thank you for reading.

Day 22

Tell me:  What do you want to do for a living?

My dream job is to review books for a living.  And to get PAID decently to do it.  I absolutely love reading.  And if I could ever find a way to get paid to do it….wow.  Right now I get paid in books, essentially, someone sends me their book for free in exchange for a review.  So that’s pretty good.

As a nurse, I would love to be some type of a “healthcare navigator” to people who are chronically ill.  Yes, they do have these positions available, but many of them are through health insurance companies, and not located in this area.  The problem with working for corporate health companies is that they want ROI (return on investment), which I understand, but you can’t quantify what nurses do in terms of money.

One company I worked for in a position similar to what I would want had all of these algorithms to determine just how much my time and advice was worth to the customer, the insurance company.  I hated being told that I couldn’t talk for longer than 10-15 minutes, that I had to hit these specific talking points, that I was restricted as to the things I could talk about.

I envision something like what I would have needed when I first got sick.  What is this disease, what are the treatments, what is the research, who are the doctors in my area that can help me?  How can I use my insurance (if they have it) to treat this illness.  What are some other resources in my area, how can I afford this?

I envision it all in one location, one person that knows the story and can navigate the person through the maze that is healthcare.  It would have to be mostly independent in order to truly serve the client, and not the insurance company.

So if anyone has an MBA and is willing to help find funding for this venture, or knows of a company that does things like this, let me know.


Help me survive this calamity!

I thought about this for awhile and finally decided (after this past week’s disaster) to open a gofundme page.

I hate the idea of asking others for help, but I’m to the point where my family is “tapped out” and I have very, very limited options where government assistance is concerned.

Apparently I have to be EXTREMELY destitute before I can be considered for medicaid.

My husband is trying valiantly to keep us afloat and afford the medication that I need, but in this economy, two, and now three jobs aren’t enough.

I may get insurance in 90 days, but I’m concerned about the whole “preexisting conditions” exclusions, and I don’t have the mental capacity to read through the Obamacare regulations.

I have been a nurse for 10 years.  I have faithfully taken care of my patients when they have needed me the most.

I now need help.

Please consider donating anything.  It would be greatly appreciated.

Click here for the link to the page.

Financial ruin and other side effects of chronic illness

People who aren’t living with an illness that they have to manage every waking moment of every day have a difficult time understanding the plight of those who battle their issues every day.

I am fortunate to have the love and support of my family (namely my parents and father-in-law).

I can’t imagine what would be happening if they weren’t supportive.

Apparently I screwed up with my student loan payments last year (I swear I made a payment), so guess who got the $2,500+ tax return money?  Uncle Friggen Sam.

This is a serious, serious setback.  My husband is taking classes to become a certified nursing assistant.  He owes nearly $700 on it and we were counting on the tax return money to pay for it.

He currently works at a job that gives him 32 hours, but won’t pay any benefits.  He volunteers to work more, but they don’t want to pay the health insurance.

I cannot work.  At all.  I can’t drive (if I do attempt it, I drive less than a mile to the grocery store).  I applied for disability.  I am trying to eeek out some financial gain from writing for an online newspaper.  Last month I made a whopping $22.

I have been sick for 7.5 years.  For the past SEVEN years, I have not had one day without pain, without fatigue, without concern for my health.  I have been ingesting chemicals for SEVEN years just to function.

Sometimes it just wears you down.

I am following the directions of multiple physicians.  I am trying to eat better and exercise.  I applied for disability, I have enrolled in a prescription assistance program for the medications that are absolutely vital.  I receive benefits from the state for food.  What else can I do to ensure I’m not homeless?  To make sure that I don’t go completely blind?

Sorry for the morose mood, just extremely emotionally and mentally spent after the past 24 hours.

Any suggestions or donations (ha!) are appreciated…

Under pressure

© Krzysiek_z_poczty | Dreamstime Stock Photos & Stock Free Images

© Krzysiek_z_poczty | Dreamstime Stock Photos & Stock Free Images

I just can’t win. Yesterday (and most of the day before) were absolutely awful.

I was hit with one of the most intense headaches I have ever experienced. And this is very meaningful because I have had migraines for the past 17 years and have been to the ER plenty of times to deal with the pain.

This one was different. My migraines are usually left-sided. Its usually an intermittent to constant pain that I can identify pretty quickly and take the appropriate medication (Treximet). They haven’t been getting to the “point of no return” lately because I have a good supply of the meds right now and don’t feel I need to ration them.

Well, Tuesday, I was hit with a severe headache that I really couldn’t identify. The pain was across my forehead, down the middle of my skull (I call it a skunk headache) and then across the back of my head and neck. The pain came on quickly and was absolutely intense. I’m talking 9/10 on the pain scale. I was literally lying in bed, pulling my hair because that sort of distracted from the intense pain I was experiencing.

I did check my vitals (like any good nurse) and my bp was 150/100.

The pain was intense. I mean, teeth grinding, grab on to the closest thing and scream pain. I didn’t go to the ER because I have no health insurance and I’m already in over my head as far as medical bills go. I took the Treximet which helped, but not as quickly and not as completely.

I finally fell asleep (with a pillow over my head, vicks vapo rub coating my face and biofreeze coating my shoulders) around 8:30 p.m. I woke up at midnight, absolutely exhausted. But still in pain (it was about a 3 at that point). I again took my Treximet and went back to sleep.

I got up with Sunshine at 6 and still had the pain. My blood pressure was still high (112/98) so I did the entire routine over again. This time I could barely move. I mean, I was so dizzy that I had to “furniture surf” so I didn’t fall. I had nausea, I couldn’t think straight. But Sunshine got on that bus. She was clean, fed and happy.

I woke up to my mom taking my pulse. I had sent her a text earlier in the morning telling her what was going on. She tried to get in touch with me (I had my phone on silent) and when she didn’t get a response she just came over.

I am so happy that she did. My blood pressure at this point was 112/100 and the pain wasn’t as severe, but still present. My mom made me call my primary care doc and she drove me to and from the appointment (and she paid for it).

My husband was basically clueless. He also has high blood pressure (usually 140/90) but he has never had any symptoms. He was at a loss for what to do for me. He had good intentions, but just didn’t know what to do.

So I went to see my PCP. The doc thinks the headache is from the blood pressure, or that my migraines are getting more intense because of the blood pressure. I already knew that I was drug sensitive. I had no clue I was blood pressure sensitive as well.

For perspective, a blood pressure like 112/100 is concerning. But some people are able to function with consistently high blood pressure without any sort of symptoms. I have seen people with bp as high as 200/120 and not feel it. That is why it is called “the silent killer”.

I have never had any problems with my blood pressure before. It actually runs low. Normal for me would be 98/70.

The doc is also very concerned about the associated symptoms (headache and dizziness). She actually wants me to use a walker.

So, she started me on a blood pressure medication. Fantastic. I am to call if the pain gets worse, if my bp doesn’t drop or if I have any more problems.

I am calling her this morning because the pain is still present. Maybe 3-4/10. But I’m concerned with taking more Treximet, as it is a vasoconstrictor and can increase blood pressure. I’m hoping she can help with something else for the pain.

I am heading back to bed now. Doc thinks it may take a few days to settle down.

I still don’t know why this happened. It could be the steroids. Or the weight gain. Or stress. Or something completely different.

Grrr!! Can’t something go right for once??

Captain Tripps

© Spartak | Stock Free Images & Dreamstime Stock Photos

© Spartak | Stock Free Images & Dreamstime Stock Photos

Despite all my efforts to stay relatively virus free for the past 8 months, the inevitable happened.

I believe I have the flu.

Yes, I got my flu shot. Yes, all my family members got their flu shots. I even got the pneumonia shot.

But from what I have been reading, this years flu shot isn’t “matched” very well. The “flu shot” combines three strains of influenza virus that the CDC anticipates seeing during the next flu season. They start the formulation six months BEFORE the vaccine hits shelves. Occasionally, they guess wrong.

The CDC (and doctors) always say “if you get the flu shot, and subsequently get the flu, you will probably have less severe symptoms”. Still doesn’t make me feel any better. Although I could imagine needing to be hospitalized if I didn’t get the flu shot. I’m still able to type, and that, to me, means that I’m not severely ill.

I do want to clarify that I received the flu shot in October of last year. And that the flu SHOT (which is a killed virus) cannot GIVE someone the flu. The flu mist, on the other hand, is a live virus and can infect someone with the flu if they have a lowered immune system or other illnesses.

I am very good about hand-washing in this household, because of my lowered immune system. I guess I am just shocked that I got it, even with all of my precautions.

The last time I had the flu was in 2009. I contracted H1N1 two weeks before the vaccines came out. That was a doozy. I literally laid in bed for two weeks. I couldn’t eat, I couldn’t do anything. I’m surprised I didn’t land in the hospital. But I had a ton of first hand experiences to share with my patients (after I got well, of course).

This one doesn’t feel like H1N1. I just feel awful. Body aches, low grade fever, nasal congestion and cough.  Chills too, can’t forget that one.

I do have a call in to the doc to see if I need to do anything else.

Not having health insurance really changes the game when you are sick. I can’t just go in to the doctor’s office and have a rapid flu test done and get tamiflu. The office visit is near $80 and I don’t even want to know how much the tamiflu costs out of pocket.

So I will just vegetate in bed. I hope this doesn’t get worse from here on out. And that I don’t infect Sunshine.

I didn’t get this from the little petri dish that is my child. Nope. It came from the other petri dish, my husband. He works at a local community college as a tutor, so he is face to face with the public everyday. He is just finally feeling better after almost a week. And he is very, very healthy.

Ick. Now I’m hurting. Back to bed I go. Maybe I can sleep it off.

Thank you Big Pharma!!

Yes, it really does work.

When I lost my insurance coverage at the end of November, I tapered myself off some of the medications that are outrageously expensive. The big ones being Lyrica and Treximet. I thought, perhaps, I might do better off the medication. And that was a bad idea.

Drug viles containing money

© Donnarae | Stock Free Images & Dreamstime Stock Photos

Apparently, I need these medications.

In the past, I have done a “drug holiday” from some substances, namely when my former husband removed me from his health insurance a few months before the agreed termination date. That was a nice wake up call.

So I was familiar with how much money these medication actually cost. At that time, I was able to get some medication assistance from a local charity.

This time, I looked into the prescription assistance programs advertised online. In particular, I went to PPARX.

I just typed in the medications that I am having difficulty obtaining (Lyrica, Topamax, Treximet) and some basic information and their search engine found several programs I could apply to. Filling out the forms online also helped me with hand cramps.

After making copies of my financial information and obtaining a new prescription (and some other paperwork for the Lyrica) I mailed the forms. Less than two weeks later, I started getting mail.

For the Treximet, Glaxo-(whatever they are calling themselves these days) sent three months worth of the medication. And considering that my migraines have increased significantly in the past few months, this delivery was very welcomed.

For Lyrica, Pfizer sent a three month supply. Directly to my door.

And the Topamax? Well, that’s the only one I haven’t been able to secure.

These programs do work. I will start back on the Lyrica tonight and maybe I can start feeling better in a few weeks.

I’m no longer worried about my next migraine. Although I monitor every headache and try to trace it back to a trigger, I no longer have to play the “ration” game. I no longer have to attempt guessing at what the head pain means. And since I get different types of headaches that can bloom into a day spent in bed, this is a wonderful development.

Migraines, for me at least, are mainly left sided…encompassing the entire left hemisphere of my head. The pain can be throbbing (including my eye, ear, skull and neck into the shoulder) or it can be one localized spear of pain, usually at the junction of the skull and neck.

Right-sided migraines are a doozy. When I start feeling that kind of “hum” on that side, I run to grab the meds. Right sided migraines have sent me to the ER on several occasions.

I used to have visual auras prior to the migraine onset. I used to see zigzags, confetti, fireworks. But since my eyes exploded last summer, I can no longer differentiate between the pars planitis and the migraine disturbances.

I am very happy that these programs exist. And that they work.


Have I mentioned recently how much I hate this disease??

There might be some ick factor here, but if anyone has suggestions on what it could be or what I could do, it would be helpful.

Apparently the methotrexate (at a less than optimal dosage), is lowering my immune system so much that I am breaking out with rashes.

I have tried baking soda (detox) baths, benadryl, using antifungal lotion, hydrocortisone cream.  And I’m on day 8 of this.

When I was pregnant, I had a horrible, horrible PUPP rash.  I still don’t understand the exact mechanisms, but it strikes later in pregnancy and it is maddening.

This rash is kind of similar.  I am running the risk of infecting my skin because I’m itching so bad.  I’m half tempted to do the “mitten” thing so that I can’t scratch it.

I finally broke down and called the doctor today.  Once I finally get disability money (from my employer), I can actually pay for a visit.  So I made one for next week when I hopefully will have said money.

I did ask the doc to call in fluconazole.  I needed three doses of that shit last fall to clear my skin.  Hopefully she will call it in and I don’t have to wait.

On one blog I read, the blogger broke out with a similar rash after eating increased amounts of sugar.  I hope that is not the case.  Because if it is, I will be itching for a long time.

The prednisone cravings kill me.  I just have this insatiable need to eat cookies, ice cream, cake.  I have been trying to curb it by not baking more cookies.  But then Sunshine had to become a Daisy scout, and now I have unlimited access to thousands of cookies.

Right now, the typing is keeping my hands busy and stopping me from scratching.

I also found out that I should no longer drive at night.  The hard way.  I spent some time at my parents’ house the other day.  I didn’t leave until 9 or so.  The ride home was quite interesting.

I can only see the middle of the road at night…the only parts where my headlights hit.  And I live in Texas, which apparently doesn’t like to make light poles.  I seriously thought about pulling over and calling someone.  And it was only a 10 minute drive, if that.

I don’t like driving in general anymore.  Muscle pain, fatigue, it constantly feels like I’m driving without power steering.  And the eye stuff just freaks me out even more.

I did find a facebook page for “pars planitis” which is now the official name of what I have.  It is a small group, because this shit is really rare.  I did get some feedback on the night driving thing in that others have this complaint, and it seems to be permanent.  Fantastic.

I see two docs next week.  I plan on researching this eye thing even more so I have educated questions to ask each of them when I go.

Even though I’m a nurse, I suffer from temporary amnesia when going to the doctors.  I have no clue why this happens.  I could advocate for a patient and correctly convey to the doc what was going on with them, but with myself, I just go blank.  I’ll blame the brain fog and chemo for this.  My husband has gone to appointments with me and pretty much has had to prompt me through the assessment.  I am so glad he has an impeccable memory.

So…back to the doctors next week (once money permits).  I am really starting to get nervous that my eyes haven’t cleared yet in the past seven months.  And that I am having such a hard time with methotrexate.


So far, so good..

A week into the new year and I’m doing ok.

Methotrexate hit much harder than usual this past weekend.  Much more nausea and the sensation that my limbs are full of lead.  Basically spent the weekend in bed, which is what usually happens.

Today I drank more water and actually took a 10 minute walk.  I sat outside for awhile and watched Sunshine play with her friends.  She is growing up so fast.  Halfway through kindergarten.

Migraines– I voluntarily stopped some of my meds due to cost.  One of them was to help with my migraines (topamax).  I have been on that medication and Lyrica since 2007.  About two weeks now without them and I think I need to go back on the topamax.  I have had a migraine 4 out of the last 7 days.  But when I refilled the prescription, I found out the hard way that it wasn’t on the list of “approved generics” at the local store.  So instead of paying $5, like I thought I would, it came out to $220.  And now I don’t have it.  I know not to even try Lyrica.  Last time I tried paying cash it was something like $8 per pill.

So I am now going to start looking at those pharmaceutical prescription help sites.  Its clear that I do have a need to be on some of these meds.

I am also getting help from a family friend to organize my medical records.  She is a legal nurse and has volunteered to help me with disability, finding free meds, etc.  It is pretty clear right now that I cannot return to my former employment.  I’m looking at other ways to make myself marketable, but one of the big issues with me is the fog that the meds cause.  And its unpredictable.  Nurses need to be on task, be able to make judgement calls.  And sometimes I can’t.  Sometimes I’m functioning just fine, but if I get to overwhelmed or too tired, I just can’t think.  Even looking at job descriptions the other day completely threw me through a loop.  I just couldn’t concentrate.

So getting help in this maze of health issues is so wonderful.  And even though I am a nurse and the product of two nurses, I still don’t know what I’m doing in terms of applying for benefits and presenting a medical case to the government.

I have also found a website that is completely dedicated to the actual problem I have.  I still don’t have a definitive diagnosis of sarcoid.  But at the last eye appointment, the doc mentioned the words “pars planitis” in addition to the usual terms of “uveitis”.  So I plugged them into the old search engine and I find a website specifically for pars planitis (www.parsplanitis.org).

Its rare.  I found it through the “rare diseases” database.  So rare the the group on Facebook for this condition only has 38 members.

Finding the website made me feel so much better.  I even wrote to the expert doc on the site and he wrote back.  Although the information wasn’t hopeful at all, it was a step in the right direction.  That doc says that I should do anything I can to get health insurance and that my case sounds very aggressive and that I am running the risk of permanent vision loss.  Fantastic.

But it did help to read the tons of information.  It helped to understand the condition better.  I have been addressing this in the wrong manner.  I have been looking for systemic reasons for why this is happening.  Per the info I have, it  can be idiopathic.  So I am switching my thinking around to focus on just my eyes.

It was also helpful to read that my docs aren’t completely off their rocker in prescribing treatment.  What I am doing is inline with what this website says is the proper treatment.  Again, as  nurse, I don’t 100% believe in everything the docs say.  Even with my eye doc, who is fantastic, I still have the tendency to be less trusting because of my 10 years of working with doctors.

So this year is going ok so far.  I still take it one day at a time, one night at a time.  That’s all I can do.