THE PRINCESS, THE GROCERY STORE AND SUICIDE PREVENTION

Mental Health/Suicide Prevention
by Sheri de Grom

I’d arrived at the perfect time and place for daydreaming. My hair color specialist had finished the foils and Tom had presented me with my second venti non-fat latte—for the day—Starbucks. I’m addicted.

Tom asked, “Is there anything special you’d like from the grocery store?”

 

“No, you always get it just right.”

With a smile and a kiss to my cheek, he was on his way.

My colorist pulled up a chair and said, “You are such a princess and don’t even know it.”

I started to say, you haven’t a clue. We’d never talked of Tom’s illness or about my life as a caregiver. We talked about books, travel, movies and such. I’d had twenty-five years of pretending that we lived a charmed life.

Princess

Princess

What I had shared with my colorist were stories of how I hadn’t cooked a meal in well over twenty years, how Tom loved to shop and as an artisan he had impeccable taste. She couldn’t imagine how Tom could shop for suits for my professional career and any number of other items for me. I hated to shop and that meant everything: groceries, office supplies, clothing, furniture, new cars, almost anything other than bookstores and there I could become lost for hours.

Additionally, I never doubted Tom’s ability to pack for me when my career sent me out of town on an unexpected business trip. Not only was his packing perfect, thinking of everything I might need, but he always included several notes expressing his love that I would find throughout my stay. I’d also come across other thoughtful gifts and often a special piece of jewelry he’d made for me and tucked away for just such an occasion.

My colorist had a different take on my allowing Tom to treat me like a princess. Her thoughts were completely foreign to me. Her comment had to do with trust. She told me she might never have gotten divorced if she’d trusted her husband to get the right kind of bread at the market.

The bread analogy is an oversimplification of individuals who never learn to trust and/or perfection is so important to them; they can’t allow anyone to do anything on their behalf.

Tom’s not always well enough to perform what he considers his responsibilities but when he is, they are all his.

When Tom’s unable to be my prince charming, I don’t hand the reins to anyone else. I pump gas when it’s essential and prefer to pour milk into the bottom of an almost empty cereal box for dinner rather than mess up a dish or go to the market. I’ll move into my workaholic mode instead of ordering or going out to eat. When it’s the two of us, we enjoy dining out but when it’s just me, I take the no fuss, no mess route.

Some find it surprising that I don’t cook or do all those things some believe to be women’s work but not Tom. When I met Tom, he was active duty military and the single father of two young daughters ages 4 and 8.

I finally had to face the horrors of grocery shopping on Father’s Day of 2012 and my list had grown to three full pages. I hadn’t actually been in a supermarket to shop since long before we married in 1986. Sure, I’d dashed into the deli section or to pick up cases of bottled water and diet coke, but otherwise, count me out.

I might as well have been on a space mission arriving at the market. I had no idea where anything was and my saving grace was another single father of four children. They more or less adopted and supervised me through the store and all the way to the check-out counter. I wanted to bring them home with me to help unload the car but thought that might be asking too much.

What does all of this have to do with suicide prevention you ask?

I used to feel guilty that Tom took over all the chores I hated. He never complained about shopping, running all the errands that came up, coordinating our calendars, ensuring routine matters such as car registrations and other odds and ends were taken care of.

One day I overheard Tom tell a friend of his that taking care of me was the best suicide

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prevention plan he’d ever stumbled upon. I wrote in my journal, John wanted to know why he did everything and Tom told him, no that’s not true. Tom said, “When I forget my anchor and my mind starts spinning, I go to the refrigerator and on the door I’ll always find a list of things that need to be done. They don’t have to be done immediately but normally within the week. If I kill myself, who will do them for Sheri?”

I no longer worry about how long the list of things to do becomes. If there’s one item on the list and Tom takes care of it and it sets his mind free of obsessive thoughts, I don’t have a problem being his princess.

 

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SUICIDE AND ACTIVE DUTY MILITARY

Mental Health/Suicide
by – Sheri de Grom

Suicide by active duty military and reservists is at a record high, about one a day.

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The numbers of active duty soldiers who’ve committed suicide are fifty-percent higher than the number of troops killed in Afghanistan in combat.

An estimated fifty-percent of the military that commit suicide never served in combat nor were they ever deployed to foreign soil.

Suicide rates are rising despite a determined push by the Pentagon to connect troops to a proliferation of resources: crisis intervention, therapy for post-traumatic crisis intervention, and therapy for other types of trauma including sexual abuse.

I believe many reasons account for the escalating suicide rates among active duty military and much of it has to do with deteriorating leadership capabilities within the ranks. Soldiers once had a feeling of camaraderie, the feeling that someone always had their back.

I frequently hear, “No one gives a damn.” Soldiers of today are not joining the same armed forces they heard stories about from their fathers and their grandfathers.

A report by the National Action Alliance for Suicide Prevention states that the stress on the active duty soldier will continue to rise – even with the pace of combat deployments declining. A primary reason for this stress is that the military is shrinking because of budget reductions.

Separation boards are thinning the ranks. Both officers and senior enlisted are being forced out. It’s not just the Army down-sizing but the Air Force, Marine Corps and Navy. Most of these individuals have been in more than twelve years and they don’t stay around if they don’t plan to have a military career.

Additional stress is resulting from soldiers being forced to leave the military and their separation from a familiar lifestyle. Suddenly careers are destroyed and family plans are left in shambles.

In a perfect world the good guys get promoted and the bad guys get punished and cut. But that’s never how it works in a giant bureaucracy like the military.

Soldiers are being asked to accept a lifestyle that is foreign to them. Before contractors came along and took over government, including the military, an envelope of safety seemed to fall around anyone entering a military base.

Before contractors, it was understood that everyone on base was military, a family member or civil service employee. This security is gone. Base housing is now operated by contractors and the homes are being rented out to non-military.

The rental of base housing is a slap in the face to active duty military. I’ll address the magnitude of problems that arrived with non-military renters in a separate blog.

A study by the Armed Forces Health Surveillance Center found that the most frequent diagnosis of military personnel medically evacuated from Iraq and Afghanistan between 2001 and 2012 was not physical battle wounds but “adjustment reaction.” Adjustment reaction causes: grief, anxiety, depression, post-traumatic stress and other mental disorders.

Mental health services are pitched as a potential solution, with the underlying assumption that the soldier is looking for a solution. But often, the service members in the greatest need of mental help are the ones most resistant to it, thus the call to action goes unanswered. This is in fact the greatest hurdle the military faces in their battle against military suicide: countering the disciplined self-reliance we train our service members to embrace.

In our perfect world, I’d place a minimum of three credentialed and licensed mental health workers (familiar with the military environment) at each platoon to help understand the daily rhythms in a soldier’s professional and personal life; someone who can earn the trust of the service members and respond immediately when needed – not after a call for an appointment. Mental health resources must be integrated into the modern garrison lifestyle.

The primary reasons given for suicides in the active duty military and reservists’ ranks are the same as most Americans in the same age grouping. The leading causes have always been: relationship issues and problems with finances.

The act of suicide is different with each individual. There’s not an easy fix and there’s no set of rules guaranteed that will save an individual. How do we know which soldier

Suicide By Drug Overdose

Suicide By Drug Overdose

needs our attention?

Suicide is complex and the trajectory toward death is as individual as the person.

I thank each of you for reading with me as we explore the difficult subject of suicide. Your love and responses have reinforced again why it is that I do what I do.

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SUICIDE, MENTAL HEALTH AND THE CAREGIVER

Mental Health/Suicide
by – Sheri de Grom

Compiled from journal notes, April 26, 1996, Washington, DC

Burdened by my bulging briefcase, I’d hoped to get a jump on the day. We were celebrating our tenth anniversary tonight and I wanted to arrive home early.

Tom wasn’t in bed as I prepared for work but many mornings he’d be up early working in his shop. That morning would soon prove to be an exception to the rule.

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I slowly made my way downstairs from our bedroom and paused at the second landing to adjust my heavy load. Looking down into the small sitting room, I had a clear vision of Tom as he sat  in an easy chair. There was no mistaking the pistol in his lap.

I knew not to startle him. His finger played with the trigger. I held my breath. My mind raced. My briefcase slid to the floor. I moved cautiously down the remaining steps and into the sitting room.

Tom had been in and out of the hospital five times in the past two years. Sometimes I thought the hospitalizations helped and other times they were puzzling. We’d gone through two additional psychiatrists and tried three new hospitals. Doctors and hospitals alike were proving to be of separate classifications. There were the ones that were more or less okay, the ones that were indifferent and then the ones that just didn’t seem to give a damn about anything other than our insurance coverage.

Our anniversary plans were defeated, again. I had to retrieve the gun and keep Tom safe.

I lowered myself to his feet. He’d retreated to his secret and secure inner space, that place where suicide knocked again and it then became my responsibility to whisper to him, “Darling, it’s me, Sheri. May I please have the gun?” Tom continued staring straight ahead. In a calm and soft voice I repeated, “May I please have the gun?”

It seemed hours had passed but only moments had trickled by. He kept his hand on the gun.

“I feel dead. I don’t care. Do whatever you want with me,” he said in that all too familiar monotone voice I’d come to despise.

“I love you. You’re going to be safe. Tom, please give me the gun and we’ll get you help. First, I must have the gun. May I please have it?”

He shook his head yes. Holding my breath, I carefully removed the gun from his hand, put it in a closet for now, helped him into his coat and we slowly made our way to the car where once again I buckled his seat-belt for the ride to the hospital.

I’d admitted him to yet another hospital. The facility was one of the highest rated in Virginia. The psychiatrist interacted with Tom during the admissions process and this gave me hope.

I talked briefly with the psychiatrist and he explained that Tom would probably sleep for at least two days but, I was welcome to stop in any time to see him. After looking at Tom’s meds, he told me there were some he would like to discontinue. He said that Tom might not know I was there that evening and if I wanted and most importantly needed to go home and rest that was understandable.

“Thank you doctor. I appreciate your kindness. I’ll be at my office if you need me. I’ll plan to come by on my way home.”

The doctor told me he would still be on the premises and that if I didn’t see him I should have one of the hospital staff page him.

The day seemed an eternity and I’m sure I looked exhausted before I reached my office. Driving the extra two hours required on the beltway to get Tom to the hospital before work, surviving the admissions process, driving another one and one-half hours on the beltway, bumper to bumper, to get to my office, depleted my negligible reserve of stamina. I was on autopilot, again.

As I drove, I peeked into other cars and all the drivers wore the same stoic expression. We were five lanes of traffic moving at eighty miles an hour with nowhere to stop in an emergency. It always amazed me that on the opposite side of the concrete dividers, another five lanes of bumper to bumper traffic traveled eighty miles an hour going in the reverse direction. It appeared we were all going round and round on some pointless, endless amusement ride.

Some mornings during my commute I’d watch drivers working on laptop computers on the seat beside them with a phone glued to their ear. Other times I’d see a young woman removing rollers from her hair and applying makeup. I’d brood angrily, while these young professionals were working or sending e-mails to lovers. Why had my life become so intolerably chaotic, always directed by the unstable requirements of Tom’s disease?

I’d gotten out of bed on a cold morning to rush Tom to the hospital, again. It distracted me and time passed faster when I fantasized that the young woman applying her makeup and fluffing her hair in the car next to mine stayed a moment too long in her lover’s bed for one more lingering caress. Maybe a baby or toddler stole those few precious moments from her?

Now that I was at my office, I wanted to stay in the car and go to sleep. It didn’t matter that it was cold. I simply didn’t want to see anyone or interact with my deputy or the staff. I didn’t care about the appointments scheduled for a full day.

How was I going to get through this day? I had to focus but I couldn’t stop yawning. Of one thing I was certain, today would not proceed as planned. Would I ever learn? Plans had no place in my life. Other people made plans, I could not. Some day the cumulative disappointments would destroy me.

THESE THINGS I KNOW FOR SURE

  • Suicide will knock again.

    Provided by Healthy Place.com

    Unconditional Love Will Survive Along With Mental Illness

  • No one is exempt from suicide.
  • A correct diagnosis is critical.
  • Bipolar disorder is a progressive disease.
  • Clinical depression can and does manifest without warning and it must be treated aggressively, and at once.
  • Firearm availability increases the risk of suicide.
  • Miracles happen with the dawning of each new day.
  • Unconditional love will see you through and the reward of beginning each new day together is the reason you do what you do.

 

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SUICIDE AMONG THE STARS

Mental Health/Bipolar Disorder/Suicide
by – Sheri de Grom

Our world shook this past week with collective sadness. We didn’t want to believe what we’d heard. Robin Williams’ suicide should not have happened.

There were brief moments in time when Robin Williams would admit to being bipolar (due to his manic behavior) followed by long stretches of the darkest depression.

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Perhaps his publicist or his wife told the media they wanted no mention of bipolar disorder in the remembrances of this gifted star. For me, a mental health advocate for reform, I see Robin Williams’ tragic death a wasted teachable opportunity. One out of five men with bipolar disorder commits suicide. The general public cannot name two accurate symptoms of bipolar disorder.

Mr. Williams spoke at Mental Health Conferences and at large gatherings of individuals with mental illness diagnoses and never once did I hear or learn later of his hiding behind his disease. He spoke openly and with great humility.

Decades of substance abuse, anxiety, rehab stays and relapses caused him endless self-doubt and shame. These feelings are normal for anyone but Robin Williams was a super star living a public life. Like so many with bipolar disorder, his instant witticism in interviews and stand-up routines were beyond the ability of all others.

It’s well know that a patient misdiagnosed as clinically depressed when they are actually bipolar is a time-bomb waiting to explode. The patient without the proper diagnosis doesn’t receive mood stabilizing medications.

Antidepressants, if prescribed alone for the bipolar patient, rather than with mood stabilizers or anticonvulsants are often a deadly mix.

I witnessed this first hand when my husband was admitted to a mental health unit for the first time on December 7, 1987. Tom was diagnosed as single episode, major depression and prescribed so many antidepressants, he was more a zombie than himself. Tom told me the combination of his medications felt as though he were putting his finger in a light socket each time he swallowed yet another one and it activated.

It was impossible for me to know who Tom would be from one hour to the next. He’d think nothing of spending $10,000 for gold and precious gems for a jewelry design he’d sketched without any idea of which market he’d be able to place the piece in and for the highest price.

Tom ordered the $10,000 in materials one day when he was manic and two days later when he’d already moved into a depression so deep he couldn’t get out of bed, the materials arrived and I’d once again lock them in the safe for a day when he might remember the design he ordered them for.

Sixty-five percent of all diagnosed bipolar individuals are also addicts per the Menninger Institute. The individuals will do anything to escape the hell the disease causes.

Tom is not an addict as most people define it with drugs or alcohol. When Tom is manic, he spends money as if however much he spends, it will be instantly replaced by some magical means. Spending money is Tom’s drug of choice.

Robin Williams said in an NPR clip, “Do I perform sometimes in a, in a manic style? Yes. Am I manic all the time? No. Do I get sad? Oh yeah. Does it hit me hard? Oh yeah. Oh yeah.”

All too often a patient with a set medical regiment will be doing so well, they decide to take a “drug holiday.” They don’t like the side effects of the drugs: weight gain, feeling sluggish, dry mouth, numbed feelings and for the artist, lack of creativity.

Not being creative is enough to make most any artist stop what they perceive to be the problem and relapse into old behavior that’s familiar and they can control.

Early in our marriage, a piece of Tom’s blown glass won first in show at the Monterey, CA Museum of Art. The award was equally prestigious as he was still active duty military and world-renowned glass blowers had entered the competition.

Tom's Blown Glass

Tom’s Blown Glass

A friend of ours made a comment I didn’t place much meaning on at the time, but I’ve thought about it numerous times since the event. At the reception to honor the artists, our friend approached us and said, “Tom, congratulations. You do your best work when you are depressed.”

Nearly one-third of those who kill themselves visit a physician in the week before they die, and more than a half do so in the month prior to committing suicide.

The media reported that Robin Williams had been diagnosed with Parkinson’s disease. This is not an unusual diagnosis when an individual has taken medication for bipolar disorder for many years. The symptoms of the bipolar disordered individual mimic Parkinson’s disease and are misdiagnosed time and time again.

Tom was diagnosed with Parkinson’s disease for two years and was prescribed medication wherein one of the medications main side-effects is suicidal behavior. Once all of the medications, to include his psych medications were taken away, the symptoms for Parkinson’s disease disappeared.

Parkinson’s disease is the same as bipolar disorder in that there aren’t any blood tests or other definitive tools for diagnosis. Both diseases are diagnosed from a set of symptoms.

It’s critical the mentally ill patient have an advocate who honestly cares about the care they receive. Misdiagnosis causes more harm than the diseases themselves.

The great majority of people who experience a mental illness do not die by suicide. However, of those who die from suicide, more than 90 percent have a diagnosable mental disorder.

Thank you for reading with me and being concerned for everyone facing the challenges of mental illness in today’s world.

 

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All About Mihran

sheridegrom - From the literary and legislative trenches.:

Aina has created a tribute to one of the kindest individuals I’ve had the pleasure of meeting since joining the blogging world. His willingness to support and urge many of us makes life that much simpler. I consider myself blessed to know Mihran, a remarkable friend to all bloggers.

Originally posted on Lyrics, Sentiments and Me:

All About Mihran

I have blogged for years now. But I never met a man as gentle and kind as Mihran Kalaydjian. Because aside from the fact that he had been so generous reblogging my posts, there was this one very warm conversation I had with him.

When I posted my condolences to our dear Ajaytao, I made Mihrank cry that day. Although I was worried if I made him cry because I wrote bad; or I wrote something for Oscar’s (coz I do have the tendency for drama), but I was really touched with his honest sentiment. Coz Mihran never met Ajay, yet he shed a tear for him. He even asked me “Why am I crying, Aina?” I told him, “It’s because Mihran, you’re a gentleman with a very big heart and beautiful soul.” And so we were both crying in the end.

And I mean those words up to…

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THE FEDERAL GOVERNMENT FACES A BRAIN DRAIN

One Woman’s Opinion
by – Sheri de Grom

 

A congressional committee has recommended federal senior government executives be required to remain in place if recruitment of a replacement is considered difficult. Federal agency leadership (the hired, not the appointed ones) is facing a brain drain and Congress is largely to blame.

It’s understandable that there’s a significant shortage of qualified top managers. There’s been a 36% increase in departures from Senior Executive Service since 2009. It’s become more and more difficult to groom a replacement in federal service than in private sector positions.

A Senior Executive may lose their job if they are even suspected of training someone for their position. A Senior Executive may announce their departure months in advance but the announcement of a new position and the recruitment process cannot begin until the position is vacated. Critical positions remain open for months, sometimes years and are often never filled.

The largest driver of senior executives out of government has been age. Nearly 80 percent of departing SES employees since 2009 was voluntary, non-early retirees.

One in five, however, left through early retirement or resignation.

Senior executives told researchers the financial crisis, pay compensation, award suspension and sequester were major factors that drove them out of federal service.

Senior Executive Employees know nothing will happen this year as congress remains in gridlock. Gridlock is bad, especially if you want action. But if you are the chosen sacrificial lamb, aka a career federal civil servant, gridlock has a certain appeal. If congress can’t or won’t do anything good for you, they also can’t do anything bad to you.

Ultimately, extending the tenure of retirement-eligible managers while mentoring and training new talent will reduce productivity during any transition period.

As with most changes brought about by congress for the federal workforce or the military, it will be too little too late.

It’s difficult for a government employee at any level to think generously about members of congress when it’s public knowledge that the leaders making the employees’ lives miserable are going home to plush accommodations as they leave their offices.

Senate Majority Leader, Harry Reid

Senate Majority Leader, Harry Reid

Senate Majority Leader, Harry Reid props his feet up at the Ritz Carlton Hotel in Washington, D.C. While he may get a discounted rate, the cost per night at the Ritz starts at $649 and goes up to $810. Assuming the senator pays $3,000/weekly, that’s more than his take-home pay. Where does the money come from for such a lavish life-style for a ‘man of the people?’ His personal fortune? Do the taxpayers of Nevada believe Senator Harry Reid is so worthy as to pick up the tab for his living at the Ritz?

While Senator Reid is relaxing, you may take a tour of the Ritz at http://www.ritzcarlton.com/en/Properties/WashingtonDC/PhotoTourPop.htm I can’t blame the Senator for loving the Ritz. I love the opulence, the charm and the feeling of no worries upon stepping through the gilded doorway.

Some say the Senator owns a condo at the Ritz. Oh, my heart be still.

Speaker of the House, John Boehner

Speaker of the House, John Boehner

Meanwhile, Speaker of the House John Boehner has long denied that his perpetual tan skin color is the result of sunless tanning. He just spends a lot of time outdoors; the Ohio Republican is known to say. If Speaker Boehner spends so much time out-of-doors, when does he have time to work?

Despite Boehner’s repeated denials of using tanning beds, he does have ties to the industry. Not only has he accepted campaign contributions from a group called the Indoor Tanning Association, Boehner lives in a D.C. apartment owned by a lobbyist for the American Suntanning Association.

In recent years, federal workers have been a primary target of deficit-fighters. The White House and Congress imposed the pay freeze, created the furloughs and shutdowns and are in agreement that feds should kick in more toward their retirement, and that future cost-of-living adjustments for retirees (federal, military and Social Security) should be trimmed, a tad, by using a new inflation-measuring yardstick.

In addition to raising retirement costs for current feds, there is talk and plans to eliminate the defined-benefit portion of the federal retirement package for future hires.

Many long-time feds, who have lived with cutback plans going back to the 1980s, have learned to grin and bear it. Lots of relative newcomers remain nervous. People who said that sequestration would never happen were proved wrong.

The good-news-bad-news (which is often the same thing when talking about political outcomes) is that Congress isn’t likely to do anything this year. They’ll focus all energy to see that everybody in Congress who wants to stay in the House or Senate stays in the House or Senate.

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SHIFTING THE COST OF EMERGENCY ROOM CARE TO YOU

Medical 2014
by – Sheri de Grom

The telephone startled her. She didn’t recognize the number but today had to be the day she’d break her rule and answer. The official sounding voice was one she’d never heard before. Without preamble, he told her his name and confirmed hers. He also confirmed her relationship to a patient he had in the emergency room of the local medical center.

Before she could ask questions, the voice on the phone was gone. She had questions: what, how, when, why an ambulance. Thank God she’d already had her shower and hurried to find jeans, sweater, run a comb through her hair, grab her purse and she was gone. Gone to the emergency room. Sheer panic had set in and she moved into auto-pilot.

How could it be? He’d been his usual cheerful, energetic self as he’d left the house that morning.

When she arrived at the Emergency Room (ER) the staff explained that her husband had passed out at work and so far, there was no known reason why.

A clerk interrupted, “Do you have your insurance cards with you?” Payment is at the front of every hospital’s mission in today’s economy.

She was advised that the specialists were running tests and she could have a seat in the waiting room.

What would happen to her if she screamed, “No, the only thing I want is my healthy husband, the man I love.” That wouldn’t happen now and she settled into a hard plastic chair in defeat.

It seemed she’d waited hours but it’d actually been less than two. Two hours with her guts turning over and over and a hammer in her head that refused to stop. It banged her front temporal lobe a million times a minute. She was sure of it.

Finally, someone from the ER staff asked her to join them and said, “The doctor will speak with you now.”

Unfortunately, she learned nothing other than her husband passed out at work, numerous tests had been completed, and nothing conclusive explained the incident. He was now resting but the doctor thought he’d be more comfortable if her husband stayed a while longer to ensure his stability.

She nodded her head yes and signed more papers. She didn’t want to take chances and agreed to a new strategy in emergency care (although she wasn’t aware that’s what was happening).

This new movement in emergency care is shifting the cost of expensive emergency care rates away from hospitals, Medicare, Medicaid and all commercial insurance companies. Patients are classified as ‘short-stay emergency department inpatients.’

National data collected by researchers at the School of Medicine at Perelman in December 2013, suggested that keeping selected patients under observation in a dedicated hospital unit with defined protocols could yield hundreds of millions of dollars in cost savings for everyone but the patient. More often than not, the patient doesn’t understand the hidden cost of being transferred to observation status until a large charge appears on their statement.

The ‘kept for observation’ status has been a topic of controversy for Medicare patients for years, and in 2012 an investigation by the Department of Health and Human Services Inspector General found inconsistency between hospitals in how they determined whether a patient was admitted or kept under observation. For Medicare patients, such ‘observation stays’ are associated with higher out-of-pocket care costs and a lower likelihood that nursing home care will be covered.

Please be aware, any time you or a loved one is moved from a dedicated Emergency Room Department to an Observational Unit, there will likely be a reduced amount in what any insurance company is willing to pay.

This shift in cost for emergency care affects all patients. It is not exclusive to Medicare and Medicaid. I encourage you to read your health insurance policy carefully.

Any stay in a hospital beyond 24 hours is considered an admission to your insurance company but you may remain on observational status per the hospital. It is a catch-22 for the individual responsible for the account.

Many same-day surgeries result in observational status (i.e. the recovery room). However, if surgical complications or recovery from anesthesia occur, the surgery patient is placed in out-patient observation status.

Please be aware, any time you or a loved one are moved from the dedicated Emergency Room Department to an Observational Unit, your cost may be higher than expected.

          The entire financial burden could be yours.

 

 

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Victims of Domestic Violence Shouldn’t Be Made Victims to Guns

sheridegrom - From the literary and legislative trenches.:

There aren’t many things I can think of that equal the fear of being stalked. I experienced this fear first hand during the time I lived and worked in DC. My work was not to make friends but neither did I plan to encounter individuals believing they had nothing left to lose if they returned to prison because they shot me. Responsible gun ownership is a must if our nation is to become civilized on any level. It’s the criminal with the guns and not the mentally ill that need heightened regulation on gun ownership. Yes, some mentally ill slide through the cracks but nothing closely related to the criminal element in today’s society.

Originally posted on The Secular Jurist:

Courtesy of americansforresponsiblesolutions.org

Courtesy of americansforresponsiblesolutions.org

By Tanya (a Secular Jurist author)

I recently received this message in an email from a group called Americans for Responsible Solutions, of which I am a member. It was started by Congresswoman Gabby Giffords and her husband to fight for gun control laws:

Victims of domestic violence and stalking are at an unacceptable risk of gun violence. In fact, 30.5% of people in New York killed by their intimate partners were murdered with a gun.That number is unacceptable.

But there’s a bill in Congress that will make it much more difficult for convicted stalkers and abusers to own a gun. Next week, for the first time in history, the Senate will hold a hearing on the links between gun violence and domestic violence.

People need to know the harsh realities of guns and domestic violence if we’re going to change the law. As it stands, the…

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HEALTH CARE FRAUD

Medical 2014BLOG - FRAUD - MEDICAL
by – Sheri de Grom

 

Compiling satisfactory evidence for prosecution of individual(s) committing health care fraud requires thousands of man hours and sheer determination that this time, this one isn’t going to get away. Often it takes years of full-time investigation on one case.

I thought you might be interested in how serious health care fraud must be before it will be considered for prosecution. The following actions occurred in June, 2014 and they represent a small fraction of current cases being worked.

The owners of Elizabethtown Hematology, PLC of Louisville, KY agreed to pay $3,739 to settle false billing to Medicare, Medicaid, Tricare and the Federal Employes Health Benefit Program.

Leonard Kibert, MD and four others of Houston, TX were charged in a 47-count indictment alleging a conspiracy to defraud Medicare of $2.9 million. A trial date is pending.

A Los Angeles physician was indicted for a $33 million scheme to defraud Medicare and one count of conspiracy to commit health care fraud. A trial date is pending.

Husband and wife owners of Ohio Ambulance Company were sentenced to prison and ordered to repay $800,000 to Medicaid for transportation services they didn’t actually provide.

Indictment of two Florida scientists for obtaining government research contracting by fraud. Additional charges included wire fraud, identity theft and falsification of records in a federal investigation. If convicted on all counts, each faces a maximum penalty of twenty years in federal prison. The United States is also seeking a money judgment in the amount of $10,000,000 which reflects the proceeds of the charged criminal conduct.

A Miami Beach osteopathic physician was sentenced to 70 months in prison followed by 3 years of supervised release as a result of a Medicare fraud scheme. In addition, the judge entered a $1.6 million forfeiture money judgment against the physician and ordered the forfeiture of his Miami Beach residence and a 2002 Mercedes Benz. The doctor is also to pay restitution to the Centers for Medicare and Medicaid Services.

The U.S. Department of Justice has ordered Omnicare, Inc., the nation’s largest nursing home pharmacy company to pay $124 million to settle allegations involving false billing to federal health care programs. Omnicare, Inc., has agreed to pay $124 million for allegedly offering improper financial incentives to skilled nursing facilities in return for their continued selection of Omnicare to supply drugs to elderly Medicare and Medicaid beneficiaries.

I could list page after page of medical fraud abuse convictions and indictments for June 2014. However, the purpose of this blog is to give you an idea of the size and frequency of fraudulent claims against Medicare and other health care insurance plans before prosecution will be considered.

I’ve seen thousands of cases wherein individual(s) are committing health care fraud on a daily basis, yet the dollars aren’t deemed high enough to qualify assigning a team of agents to investigate the activities in order to press federal charges.

Due diligence is required of every citizen to insure their insurance company is not being gouged by a medical provider and they are using your name in the process. Insurance fraud is the fastest growing criminal activity of white collar crime in the United States.

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GUNS, MENTAL HEALTH, VIOLENCE AND SUICIDE

 

I didn’t know the title of the theme song for the long-running television show MASH, but Tom did. I wasn’t surprised to learn that Tom could name the song, Suicide Is Painless, and sang along with it whenever it played on the radio.

I hadn’t given much thought to suicide before bipolar became a third party in our marriage. Tom and I’d agreed before we married that we didn’t want guns in our home.

I’d grown up with gun racks and loaded rifles in pick-up trucks in rural Kansas. Tom was taught to hunt as an adolescent and obtained sniper status for the military. Thankfully he was never asked to serve in that capacity.

The military was more interested in Tom’s intellect than his shooting ability and that afforded him comfortable working conditions. His military uniform was most often a suit and tie. He served as a key component of the Army’s Organizational Effectiveness Team. Instead of going to the field, his travel consisted of hotels where turn-down service was provided and a chocolate waited on his pillow.

There’s no disputing that mass shooting episodes are horrific. For the purposes of this blog, I’m addressing the 88 gun-related deaths that occur each day in the United States and not the mass shootings.

Of the 88 people that die each day from a gun: 90 percent of those deaths are suicide, a high portion of which are committed by seniors and individuals living in rural areas.

In cities, gun-related deaths are typically homicides. If we want to reduce this number, it comes to reducing gun-related violence on the streets.

Guns and gun legislation are topics we hear about daily. I couldn’t delay updating my research findings any longer. As recently as May 8, 2014 a team of investigative researchers at the American College of Physicians (APC) based all of their policy decision on scientific evidence.

Family doctors and internists have been identified as the first line of defense against both gun violence and suicide. The APC stated, “When it comes to reducing gun-related violence, physicians must play a vital role in making firearm safety a public health issue so that policy and law are based on scientific evidence.”

I’m in agreement with the APC. The United States will never have appropriate gun legislation while it’s tangled in second amendment rights.

The media has played into the mental health status of each mass shooting. We’ve watched them unfold in the news.

We’ve seen serious mental health issues connected to the shootings that should have been addressed years before these tragedies occurred. These incidents should have been no surprise to the parent(s) or guardian(s) of the shooter firing the weapon(s). The behaviors developed in the mind of a psychotic individual do not divulge over night.

Overall the mental health issues surrounding gun violence are in a complex area that requires a nuanced approach.

People with mental illness are more likely to be victims than perpetrators of violence. Individuals with mental illness who receive appropriate treatment are less likely to commit acts of violence.

Scientific Data Revealed: 32,000 deaths per year are caused by guns (roughly 11,000 to homicides and 19,000 to suicides).

Non-fatal gun-related injuries are more than double that of deaths.

My husband, Tom and I have often talked of the distorted truth regarding bipolar disorder and especially how the disease is misrepresented in the media.

The following facts about mental illness and violence were compiled by the American Psychiatric Association (1994). Fact Sheet: Violence and Mental Illness. Washington, DC: American Psychiatric Association. The Fact Sheet has numerous citations and I’m happy to pass the individual sites on to anyone who’s interested.

FACTS ABOUT MENTAL ILLNESS AND VIOLENCE

Fact 1 – The vast majority of people with mental illness are not violent.

Fact 2 – The public is misinformed about the link between mental illness and violence.

Fact 3 – Inaccurate beliefs about mental illness and violence lead to widespread stigma    and discrimination.

Fact 4 – The link between mental illness and violence is promoted by the entertainment and news media.

FACTS ABOUT MENTAL ILLNESS AND VIOLENCE BY LEADING RESEARCH FACILITIES

“Characters in prime-time television portrayed as having mental illnesses are depicted as the most dangerous of all demographic groups: 60 percent were shown to be involved in crime or violence.” (Mental Health America, 1999)

“The vast majority of people who are violent do not suffer from mental illness.” (American Psychiatric Association, 1994)

“The absolute risk of violence among the mentally ill as a group is small . . . only a small proportion of the violence in our society can be attributed to persons who are mentally ill.” (Mulvey, 1994)

“People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime (Appleby, et. al., 2001). People with severe mental illness: schizophrenia, bipolar disorder or psychosis, are two and one-half times more likely to be attacked, raped or mugged than the general population.” (Hiday, et. al., 1999)

This blog is the first of a series about Tom’s and my many struggles to keep our home free

Official Logo for 2014 Participants

Official Logo for 2014 Participants

of guns. It should be simple but it’s not. I’ve spoken numerous times in multiple congressional committee meetings about the necessity of protecting the individual who wants to harm him or herself. A data base would not be difficult to set up nation wide and with volunteers such as myself, the data entry would be a free public service. I’ll discuss attempted suicides and how we’ve coped with the situation when it appeared in our lives.

Suicide and attempted suicide are difficult subjects to write about. I understand that sometimes the pain is relentless and there seems no place to turn. I fully understand how suicide can seem the only solution.

Suicide is anything but painless.

 

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