ACA/Medical 2015/Insurance/Bipolar
by – Sheri de Grom

An irony of the Affordable Care Act (ACA) is that millions of people have gained access to insurance but their deductible is so high that it’s left them uninsured.

Providers are reporting the largest increase in bad medical debt for people with insurance since the great depression.

Insurance has always been purchased to cover loss. The Affordable Care Act turned healthcare upside down and we see the unfortunate results daily. Healthcare is no longer insurable.

The truth about the ACA is that a high percentage of enrollees have plans with elevated yearly deductibles. The amounts are so high, people report they are still uninsured because they can not meet the deductible.

The rise of high-deductible plans is driving the rise in medical debt. The average deductible for a single person enrolled in an employer-sponsored healthcare plan reached $1,217 in 2014, a 7% increase over the previous year. By 2019, providers could see a 50% decrease in the amount of revenue they will be collecting directly from patients. Thirty percent of that amount, or as much as $200 billion will be written off, according to industry forecast.

Healthcare providers once considered individuals with insurance to be low risk for bad debt. Today, those without insurance are being joined by individuals with high-deductible insurance and they now owe thousands of dollars in medical debt.

New patients are routinely asked if their policy was purchased through the ACA marketplace or if it is employer-backed. If the answer is ‘marketplace’, the patient is often turned away. The medical practice understands the marketplace insurance comes with high annual deductibles and high co-payments regularly leading to uncollectable debt.

Hospitals and physician groups alike are learning they must approach debt collection in a different way than in years past.

Small physician practices do not have as much room for give and take negotiating debt with their patients. They want to maintain the personal touch but the Affordable Care Act has taken away what were once physicians practicing medicine with that hometown touch.

Hospitals and large medical clinics are learning from retail about collecting bad debt:

  • Keep bad debt in-house. Once a collection agency is involved it can cost as much as 33% of any unpaid balance for the agency to manage the debt even if collections are unsuccessful.
  • Pre-screen patients with a short financial form for any service over $250. Reach a payment schedule before treatment and the first payment before the treatment.
  • Try to establish a conversation with the patient regarding their bad debt. Studies have shown the patient will pay part of their bad debt when treated with kindness and understanding.
  • Always when attempting to collect a bad debt, give your employee the power to negotiate the bad debt. It’s better to get $500 cash today than to never collect the $2,500 due.

Collection prospects decreases as medical debt increases. The shocking reality is healthcare providers today are collecting $0.18 to $0.34 on the dollar from patients with high-deductible plans. Once a bill exceeds 5% of household income, a patient’s propensity to pay drops to zero.

You, your families and loved ones have the right to appropriate healthcare. We all must meet our financial obligations but we all deserve to be treated with human dignity. When illness strikes, we all need that extra touch of kindness.

The latest fallout of the Affordable Care Act, on a personal level for me, is that my internist has decided to retire at the end of the year. In his words, “The Administration, Congress and the Supreme Court do not know my patients or how to care for them, medically. I’m the doctor and you are my responsibility. I can no longer care for you in the way I believe is best for your health.”

In the past 40 years I’ve only had one internist I liked as much as the one I’ll have until the close of 2015. They both saved my life with their excellent diagnostic skills. However, I understand the continuing frustration my current internist faces daily. It is indeed maddening. He was recently elected as the best internist in a 21-state region by his peers. I would have gladly added my affirmative vote.

Thank you for your support, friendship, love and the many prayers you bestow upon Tom and I daily.

Many of you have become like family to me and I cherish the notes that arrive by e-mail [even if I don’t answer immediately], the cards that arrive by mail, and telephone calls as if you know when I need them the most. You always ask about Tom and of course the story of how we’ve survived all these years with his bipolar disorder has been the primary focus of my blog from it’s inception. For years I asked psychiatrist for books, journal entries or anything I could read so I would know what to expect from his bipolar disorder as we entered the afternoons of our lives. Now I understand why nothing had been written all those years ago. THE DOCTORS ALL EXPECTED TOM WOULD BE DEAD.

An update on Tom’s health: He’s still bedridden many days due to any number of diagnoses playing havoc with his body. However, on the days he’s able to be up and about; he is able to do so by using the walker.

After 7 months of being mis-diagnosed and having such horrific pain on the bottoms of his feet, we have a new rheumatologist that correctly diagnosed psoriatic arthritis. Unfortunately the oral medications didn’t work and he’s now on a schedule of infusions. We recognize the risk involved but when he feels up to walking, he can do so as long as he has the energy.

The horrendous coughing I talked about in my blog of Aug 30, 2014 may have finally met its match in a new Pulmonologist who continues to work with us. He’s definitely a keeper for Tom’s medical team. The coughing hasn’t stopped but, we now know how to treat it and Tom doesn’t spend the night sleeping on the bathroom floor.

This doctor did much testing and by placing the pH probe for gastroesophageal reflux at the entryway where food leaves the mouth and starts the beginning of its journey to digestion, he was able to determine the initial cause of Tom’s coughing. Tom’s had dozens of pH probe tests in the past but they all read negative because the probe was placed much lower, as is normal for other patients. [Let’s face it, there’s nothing normal about Tom’s body].

Tom has never had any of the symptoms of Gerd or Reflux disease. This is the same as he’d never had chest pains but he was still on the edge of dying from a 100% left bundle blockage of the heart. For me, Tom’s caregiver, I have witnessed years of Diagnostic Overshadowing, which I talked about in my blog of Aug, 30, 2015. As a result of the coughing not being diagnosed and the Gerd not being tested properly and diagnosed, Tom’s trachea ‘(windpipe) the airway that leads from the larynx to the bronchi, which are airways that lead to the lungs’ don’t function. He has developed tracheal stenosis as his trachea is shredded from top to bottom. Twenty-five years of coughing and extreme acid causes Tom’s trachea to collapse without warning and when it does, he must have immediate help. HE CANNOT BREATHE.

This new development has caused a complete shift in my caregiving and I’m learning as I go. Every day I thank God that I can help.

His daily intolerable migraines have become severe and include projectile vomiting, sensitivity to light and all that most of us with migraines know as the major symptoms. His heart problems complicate his migraines and their treatment. We are trying some herbal remedies and I’m open to any non-narcotic suggestions.

I can honestly say Tom’s medical issues are no longer about being bipolar. The physical illnesses attacking his body are a direct result of diagnostic overshadowing. Bipolar disorder is one of his 32 diagnoses we worry the least about. However, we still keep occasional appointments with his masterful psychiatrist.

Until next time, love to all. My blogs have been further apart this year because my responsibilities at home have increased a thousand fold. I have massive amounts of paperwork to prepare both Tom and I for the next phase of our life. However, I hope to be around to pop in with a blog here and there. I’ll also do my best to keep up with reading and commenting with you. I do love our conversations.

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VA/Veterans/Medical 2015
by – Sheri de Grom

Our Veterans Suffered Unbelievable Pain and Died Unnecessary Deaths

Our Veterans Suffered Unbelievable Pain and Died Unnecessary Deaths

The most recent Inspector General (IG) report reveals egregious problems with enrollment data within The U.S. Department of Veterans Affairs (VA). The report identified so many complications it was impossible to determine how many veterans were actively seeking health care from the VA.

Data limitations make it impossible to decide how many now-deceased veterans have asked for health care and never received so much as a reply.

More than 300,000 American military veterans likely died while waiting for health care—and nearly twice that many are still waiting—according to a new VA Inspector General report.

The VA has acknowledged that its enrollment process is confusing and that data integrity and quality are in need of significant improvement.

The actions of a few have wipped out the heroic measures carried on by thousands who care for our veterans.

The actions of a few have wipped out the heroic measures carried on by thousands who care for our veterans.

The changes that have come about are because a whistle-blower reported that more than 200,000 veterans with pending applications for VA health care were likely deceased. The IG report substantiated that claim and others, but said there was no way to tell for sure when or why the veterans died.

Deficiencies in the VA’s information security—including a lack of audit trails and system backups—limited investigators’ abilities to authenticate some issues fully and rule out data manipulation.

As of June 30, 2015, the VA has contacted 302,045 veterans by mail, asking them to send required documents to establish eligibility. To date, the VA has received 36,749 responses and enrolled 34,517 veterans.

The above ratio of numbers represents a wasted expenditure. Would the same 36,749 have answered if flyers had been posted by volunteers at shelters, local markets, and places where veterans gather?

The homeless population isn’t going to answer mail from the VA. Many of them have

We thank our Veterans by allowing them to live under bridges and on our streets.

We thank our Veterans by allowing them to live under bridges and on our streets.

serious mental health problems and others have given up and wonder how their lives could have gone so terribly wrong. We have provisions for the homeless population to receive mail at United States Post Offices but I wonder how many homeless vets are aware of this fact.

Twenty-two veterans still commit suicide every 24 hours. Of those 22 veterans, only 17 had enrolled for services at the VA and the other 5 are unaccounted for. My suspicion is that the number of unreported suicides is much higher due to states not reporting suicides to the federal government. Nor do the states report if the deceased individual had veteran status. We simply don’t do a good job of identifying our veterans who need help. Some don’t want it and others don’t know how to use it.

I’ve maintained my Federal Blue Cross/Blue Shield insurance for 30 years so that Tom and I would never be at the mercy of the VA and Ticare for Life. I’d seen so much that was wrong and had experienced too many bad customer service encounters in my early days of working for the government. I was determined; Tom would never become a victim of the VA system. I wanted us to always have a choice of the best medical care available.

We gave them so many reasons not to trust.

We gave them so many reasons not to trust.

I believe the VA’s low response to the letters they mailed signifies a continued distrust of the VA by Vietnam era Veterans. Additionally, thousands of Iraq and Afghanistan Veterans have had a disturbing reentry into civilian life and enrollment for health care benefits is difficult at best.

The number of veterans who received the letters and have other health insurance is unknown. Like Tom, they would have private health insurance and if they had retired from the military they would be eligible for Tricare payment for any deductible when using their private health insurance.

Federal law mandates everyone eligible for Tricare, Veterans included, must enroll in Medicare Part B. The Veteran would not need to contact the VA for health care services.

There are advantages of being enrolled in the VA and I urge any qualifying veteran to do so. They are building programs for treating the elderly with dignity. The VA has realized home care is less expensive and more beneficial to veterans and family members than nursing home care. The veteran stays in his/her own home and funds are made available for care in the home setting. Are the funds adequate; that remains to be seen.

Gaining access to these funds is not easy. It requires a united front from all caregivers to receive equal distribution of aid and assistance. I will be discussing this in a future blog.

Who will Congress give priority to; the Veteran or the illegal immigrant? We know where the loyalties of the Administration stands.

Who will Congress give priority to; the Veteran or the illegal immigrant? We know where the loyalties of the Administration stands.

If the VA is to survive, changes must be made. Congress promised to put into place regulations to remove those taking advantage of the VA program, e.g., administrators not doing their jobs and many others. The VA will not improve for our veterans until we can give them what they deserve for giving us the best years of their lives.

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Mental Health/Suicide/Caregiver
By – Sheri de Grom

How could dying be more tempting than living? How could such a desperate act seem like a reasonable solution to one’s problems?

BLOG - SUICIDE PREVENTION MILITARY How was I to know that I would be faced with my own suicidal thoughts? I was totally bewildered one spring, when the first stems of perennials were pushing their way through the earth, to find I was suicidal.

Tom was in the hospital to keep him from hurting himself. Somehow, that day, I lost my will to live. Suddenly suicide seemed an option. My endurance had taken a holiday without me.

Morti curled in my lap, purring. “Morti, whatever will I do?” Did he sense I needed consoling? My comfort zone had disappeared. I’d slept last night but my body screamed, ‘no you didn’t!’ My eyes were so dry, a sand truck could have off-loaded into them. No amount of artificial tears helped.

Gazing out the French doors Tom had installed, I watched the quail scurry around my herb garden. The hen, with her soothing coos, coaxed the chicks away from their protective shelter near the rushing brook. The scent of wild pineapple sage wafted through the air.

My mind wandered to the office, and I realized I’d have to place work on the back burner. This didn’t set well with me but I had to find out what was happening to my life. I had an appointment to talk with the lead prosecuting attorney at the U.S. Attorney General’s Office. He’d called me about our Veteran Affairs case, and he wasn’t known for calling anyone. He was used to investigators begging him to try their cases.

He’d understand, but I didn’t want our forward momentum stalled. Arrest warrants were already being issued. I didn’t cope well with postponing things until the next day—not when it came to my work.

It didn’t make sense that I was thinking about postponing my life, forever.

Who could I talk to? Not God. His Word ordained that suicide is a sin. God already knew what I was contemplating that day as I wandered out into my gardens. I felt the breeze caress my skin and tease my hair. The mammoth cottonwood tree played a rustling song, and the brook near our front door reminded me further that even if I left this extraordinary earth, life would go on. Why was I deliberately considering leaving my life when nature could still make me feel so alive?

I planned my own death and my strategy would ensure insurance payments for Tom’s continuing care. It seemed so faultless, that plan of mine.

I would soon be traveling from Fort Ord, California to the Presidio of San Francisco for a meeting. Two co-workers were also going, and I made excuses to ride in the back seat of the car. Some time before I had scouted for and found a location near the Santa Cruz Mountains that seemed ideal for opening the door and jumping from the car to guarantee my death.

Farley jumped up as a tiny rabbit scampered past. He knew he wasn’t permitted to chase the little fellow but he really wanted to take off at top speed.

Farley’s interruption of my thoughts racing in circles reminded me of how uncomplicated it might be to take my own life. I promptly identified with the workings of an irrational mind and how intolerable pain annihilates logical thought to meaninglessness.

The despairing loneliness, the feeling of total uselessness to the man I loved, and the knowledge that life could no longer be the same magical journey we’d once known, made life seem unbearable and intolerable.

I tried putting these terrifying thoughts behind me, but it became impossible. Invincible pain invaded my thoughts, penetrated my rational existence and endeavored to destroy me. Tom’s pain swallowed mine. It was easy to share his anguish and terror.

My world, engulfed by Tom’s illness, was crushing me. I had to find something I could embrace to save my life and not become another casualty of Tom’s disease.

Tom has attempted suicide multiple times. I’m astonished that this wonderful, loving and sensitive man can possibly cope another hour. My first suicide plan of 1988 seems shallow when I look honestly at the lowest point of Tom’s anguish. I continue to discount myself for having the same suicidal leanings.

What I’ve learned about myself is that I grieve for the loss of the Tom I once knew and that

Shattered Dreams

Shattered Dreams

causes me tremendous pain. Tom was the man I’d waited for all my life and then all too quickly, he was snatched away. Yes, he has bipolar disorder but he now has an even larger problem and that’s the physical damage years of medication have taken on his body. Tom has never indulged in illegal drugs or alcohol. Every pill he’s swallowed has been by a physician’s order and now his body has been destroyed.

All of my dreams vanished with Tom’s illness. I’ve learned not to linger over new dreams as they lead to more disappointments. The disappointments lead to depression and the depression to my own thoughts of suicide. As Tom’s 24/7 caregiver, I have to keep myself safe. Who would take care of Tom if I were gone?

I’ve talked with you previously about how invaluable my therapist, Elizabeth Crone, has been in helping me discover how to cope with so many of my life’s losses. When I became a full-time caregiver for Tom, I realized I had to face my own losses:

  • The loss of a professional career I’d worked hard to develop. I was considered the best in my field. I was able to stay on for 20 years but at that point, I had to retire and become Tom’s full-time mental health advocate and director of his medical care.
  • My financial security is gone. When Tom is manic he spends money uncontrollably. This is his one vice and it has nearly destroyed us on more than one occasion.
  • My social activities are gone. We were involved in many activities as a couple and I was involved in several Boards of Directors, but I never know when Tom needs me because I’m the one on call 24/7.
  • I’ve become more a mother than a wife and I miss having my partner by my side. The man I used to make decisions with, the man I could spend endless hours engaging in quiet conversation — I’ve lost all of that.
  • Caregivers the world over need help and the tip of the iceberg hasn’t been touched. I’ll be bringing this subject up more often as time goes by.
  • Tom didn’t ask for this horrific disease and I as his wife have dedicated my life to learning everything I can about it. More literature is becoming available with each passing day.
  • I’ve learned, but not accepted, I’m on first for all matters that keep our household and our relationship operating at whatever optimum level we are capable of having. I want to get it right but I know, I must take care of myself in the meantime.

Once again, thank you for reading with me. Do you have ideas on what might make a 24/7 caregiver’s life easier on a daily/weekly/monthly basis? I’m looking for all suggestions you have to offer.

I appreciate the thoughts and ideas I hear from each of you. Often the thoughts you have to offer me are lifelines I seek in the middle of lonely long nights when I’m battling insomnia.

Have you ever felt as though you couldn’t face one more tragedy, one more blow to your dreams or one more task you must put before your own dreams and aspirations? I ask of you to remember, you are as important as the individual you are caring for and each of us, the 65 million unpaid family caregivers, must be recognized for the sacrifices we make each and every day.

September is set aside to raise awareness of suicide prevention; it is National Suicide Prevention Month.

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Mental Health/Caregiver/Medical Care 2015
by – Sheri de Grom

Imagine my surprise when I read in the March/April 2015 issue of Psychology Network that psychotherapy was in a decline or even in a freefall.

According to a study published in the December 2010 issue of the American Journal of Psychiatry:

  • The proportion of people getting only psychotherapy in outpatient mental healthcare facilities had fallen from 15.9 to 10.5 percent between 1998 and 2007. That’s by more than a third.
  • Individuals receiving both therapy and medications had fallen from 40 to 32.1 percent in the same time period.
  • The number of people receiving only medication had increased from 44.1 to 57.4 percent.

In the June 2013 issue of the Journal of Clinical Psychiatry, researchers reviewed 34 studies of mental health treatment preferences (patients and non-patients) for anxiety and depression and found that people were three times as likely to favor psychotherapy over medications.

I remember the night during Tom’s first mental health hospitalization when he said, [and he was spot on] “I’m not coming home until you agree to see a therapist at least four times. If you believe you don’t get anything out of it, then stop. It will be your choice.” You may read that blog here.

I don’t know what clued Tom into the idea that I could possibly need a therapist. He was the one in the hospital. I was the strong one. The one that could do it all. The one who was rigid about what she ate and who didn’t go to bed until she’d run 10 miles no matter the time of day or night. I was the one with only one female friend because I didn’t trust women and I refused to work in any environment with women. Mine was a man’s world.

I guess you could say Tom recognized several traits I might want to explore and get off my back. It’s 20+ years later and I’ve never once thought of stopping therapy. Until I retired, I had to hide where I was going, but I never thought about stopping. Had my destination been discovered, I would have lost my security clearance, immediately followed by the loss of my job.

My opinion is that medicine alone will not help the depressed, the anxious, the individual with PTSD, the addicted and many other diagnoses. Life’s bumps can and do take over a person’s mind and a good therapist is worth their weight in gold.

I’ve been with my current therapist for eight years and she still doesn’t let me get away with anything.  I can’t begin to explain the depth of my growth since Elizabeth Crone came into my life. If she weren’t my therapist I believe we could be really good friends but she’s far too valuable to me as my therapist.

I love those moments when something we’ve talked about in a session comes together and it doesn’t matter where I am, I understand my new revelation comes from the work Elizabeth and I have done.

The worldview of therapy remains unfriendly and that leads to the continuing stigma which reigns supreme over mental health care.

Within the field of psychology there are numerous forms of sustaining brainwashing against psychotherapy. The Diagnostic and Statistical Manual of Mental Disorders [DSM-V-TR] provides a faux legitimacy to artificially constructed psycho-medical disorders. Big pharmacy has financial, social and political clout which out-classes Little psychotherapy on every measure. Direct-to-consumer ads for psychotropic drugs turn every TV watcher or magazine reader into his or her own personal psychiatrist.

A continuing decrease in insurance reimbursements for therapy, as well as increasing reimbursements for prescriptions, means that if people want therapy, they’ll have to pay for it themselves.

What happened to mental health parity?

Having a therapist the years I worked for the government and ran interference for Tom’s healthcare, both physical and mental, became a valuable tool in my tool box for my own sanity.

My career moved us often and I never had the opportunity to develop a lasting relationship with any of the professionals I saw before I retired. They did manage to hold me together while dealing with a demanding career, difficult step-children and Tom’s illness.

Of the 15 therapist or so I met with, I recognize most of them saw their role as holding me together while I managed a difficult career and cared for Tom. I know they weren’t overlooking my underlying needs; they were giving me what I needed on a short-term basis.

Caregivers Must Have Help.

Caregivers Must Have Help.

I’m positive every full-time caregiver needs a therapist who understands their role in assisting in whatever the caregiver’s complex set of problems might be.

Why do I tell you about my therapeutic relationship with Elizabeth and expand on what a difference she has made in my life? She has set the gold standard for me and I recognize God answered my prayers when I held out my hands in prayer and begged for someone to enter my life who could help me understand me.

I continue to pray for friends who tell me they’ll never spend money on a therapist. They tell me they are never going to talk about their past with anyone. I haven’t changed anyone’s mind and if it hadn’t been for Tom’s ultimatum, I’d still not know why I don’t like water except to drink and shower or why a long narrow shop had the power to keep me out on the street, no matter how much I wanted to enter. I couldn’t fasten my seat-belt before I entered therapy in 1987.

I’m not following the research trend. If I don’t see Elizabeth as often as I did when we first started working together it’s only because we’ve worked hard and have accomplished more than I could have ever dreamed. I only have to look back in my journals to find the person I used to be.

Welcome to fall everyone. I’m looking forward to cooler temperatures and hope to have time to turn the soil and prepare it for the planting of wildflower seeds and much more. I’ve been looking at the seed catalogs for months and it’s time to place my orders.

What are your thoughts? Do you think medication alone is enough for mental health? How do you wish to be cared for?

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Mental Health/Discrimination/Diagnostic Overshadowing/Mortality/Medical Care 2015
by:  Sheri de Grom

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said,

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, “It is never simply a record of daily events.”

Why do I continue to question the ongoing discrimination of medical professionals toward individuals with a mental health diagnosis?

I see the defeat in Tom’s eyes when he tells me, “There’s no need to go to the doctor or even try; nothing will change.”

Logo for those of us promoting advocacy on behalf of the mentally ill.

Logo for those of us promoting advocacy on behalf of the mentally ill.

Given our experiences over the last two decades in finding both appropriate mental and physical health care for Tom, I shouldn’t have been surprised by the statistics reported in an exhaustive report, “Morbidity and Mortality in People with Serious Mental Illness.” This report provides a comprehensive review that provides an overview of recommendations and general call to arms by the National Association of State Mental Health Program Directors.

The study outcome – physicians and other healthcare clinicians are responsible for individuals with a mental health diagnosis dying 25 year earlier than those without a mental illness.

This 25 years does not include the number of deaths caused by other problems in the medical community or other deaths related to comorbidities of having a mental illness.

First on the list of ignored illnesses is unsurprisingly, cardiovascular disease. Two large studies from reputable research groups revealed that patients with both a mental illness and a cardiovascular condition receive about half the number of follow-up interventions, like bypass surgery or cardiac catheterization, after having a heart attack than did the “normal” cardiac patient.

Commonly overlooked chronic physical conditions endured by bipolar individuals include: migraines, irritable bowel syndrome and manual heart valve prolapse. No one knows why these diseases are most often connected but ignored.

Most shocking to me are the subtle findings in various studies that deserve special note. Although the numerous studies cover 29 countries, there’s no evidence of a difference based on the source population or geographic region being studied. The increase in mortality reported in all studies maintained a relatively high level of mental health care. Rather than finding a decrease, it appears that the recent improvement in life expectancy for the general population, such an improvement has not reached the population with mental illnesses.

Tom and I have often talked, he would have died long ago if it weren’t for me pushing and shoving the physical medicine department to care for Tom the same as they did for me. I demand the same respect and attention. This past year Tom was misdiagnosed for over seven months for a condition he did not have and if I hadn’t demanded, we’d still be in that deadly cycle. I believe we are beginning to see the light of having a new team for Tom’s healthcare but it’s been most difficult. As his wife and 24/7 caregiver, I would not give up.

According to a review of 4,650 patient profile studies done by the Institute of Psychiatry at King’s College, London from 1990-2000, 0ver 90% of people with a serious mental disorder–including bipolar disorder, major depression, schizophrenia and schizoaffective disorder–end up with a wrong medical diagnosis and are under-treated.

Our experience at yet another ER demonstrates clearly what often happens when an individual with a mental health diagnosis presents for medical help.

Tom had a harsh cough develop a week before Thanksgiving, 2014. He’s had this particular cough off and on for well over 20 years and we cope with it 2 to 4 times a year, every year, since it started. We’ve tried every suggestion tossed our way: every grandmother’s remedy, every witch doctor’s potion, ideas from fellow bloggers and even ideas shared over the garden gate. Nothing has worked.

I’ve accepted we’ll never have a diagnosis for his cough. Tom has undergone extensive testing to include 10 days in a hospital isolation unit where world-class pulmonary physicians tested him for every exotic disease imaginable. At the end of the 10 days they said they didn’t have an answer as to why he coughed or how to treat it. They admitted the cough was alarming but they didn’t know why the cough started or why it stopped. I continue my research with every new respiratory virus reported by the Centers for Disease Control (CDC) [and follow advances reported on old viruses] because I am Tom’s #1 advocate. Giving up is not an option!

The doctors dismissed Tom from isolation to home with an inconclusive diagnosis and no recommendation for follow-up. He doubled over in a fit of deep coughing as he was discharged from the hospital.

What I know as Tom’s wife is the severe coughing is one of the many medical conditions plaguing Tom and thus affecting his health negatively as well as our quality of life as a couple.

When Tom coughs, I grit my teeth, knowing I have nothing in my toolbox to help him. I don’t play the helpless wife well. I want results and I want them now! It’s a vicious circle day in and day out. The non-stop cycle of coughing throws him into dry heaves and many nights it’s easier for him to sleep on the bathroom floor. He no longer has the energy to make the trip from our bed to the bathroom.

What I do know is that Tom didn’t develop the cough until approximately 5 years after the

Medication Prescribed - Getty Photo

Medication Prescribed – Getty Photo

start of massive amounts of psychiatric medications. One of the advantages of having a detailed journal is being able to compare the specific start date of new medications and types of therapies along with any new medical symptoms.

What do I do now? The cough is severe: Tom falls out of bed and out of his wheelchair from coughing. He loses his balance from simply walking across the floor. I’ve had to make accommodations to insure he doesn’t get hurt while falling. Using a walker strips him of his dignity. My proud American soldier standing tall with squared shoulders beats himself up and I do what I can to ease the burdens haunting him.

Scooter loved to hop on Tom to check on the breathing process.

Scooter loved to hop on Tom to check on the breathing process.

At home, my precious Miss Priss, has become Tom’s safety net. Scooter, Tom’s shih tzu and constant companion is terminally ill and while Scooter still sleeps next to Tom, Scooter knows he can no longer be Dr. Dog for his master.

Miss Priss has been my constant companion for the past 8 years. She has a new job now. I rarely see Tom that my girl

Miss. Priss aka Lady Lansdowne Priscilla has taken on new duties.

Miss. Priss aka Lady Lansdowne Priscilla has taken on new duties.

Priss isn’t at his side. Because of Prissy I’m able to leave the house and work in the garden. If Tom needs me or if she even thinks Tom needs me, she bounces to the door and barks for me to come immediately.

I beg doctors to prescribe something to relieve Tom’s cough and they say, “I don’t feel comfortable prescribing anything, not with everything else he’s taking. How about gargling with warm lemon water?”

I want to scream and Tom will bow his head and say, “Please, just let me die.”

I spent 2 full days calling Tom’s doctors asking for help for his cough. I had to reach someone before all offices closed on a Friday night in late November, 2014.

Again, no one returned my calls and we were left at the mercy of the emergency room.

I’ve never believed a doctor should be fined by Medicare. However, if there is sufficient proof of notice that a patient requires urgent care and that patient gets no response from their physician shouldn’t that physician then be fined the amount Medicare has to pay for the ER visit and all ancillary charges? Those physicians, not returning my calls, were all on Tom’s medical team and had been for many years. The indifference I sensed drove me over the proverbial edge. Each of them knew of Tom’s failing health.

It was at this point in Tom’s treatment that I started putting together a new treatment group of specialists for the man I love. We’d gone through medical hell for the past 6 months and little did I know we had another 6 months ahead of us. Our saving grace was a top psychiatrist at the VA. He is still #1 on my list of doctors to ask what is best for Tom. He’s shown more respect and caring for Tom than any doctor we’ve had the pleasure of meeting and working with.

We’d discovered, over many years of trial and error, that Robutussin with Codeine would stop the violent bouts of Tom’s coughing. It allows the reflex muscles that cause the violent and non-stop cough to relax. Tom can return to living a life without constant dry heaves, but his body remains so weak that he collapses into himself whenever he stands up.

What we didn’t know until [6 months later] and through constant searching for a physician that honestly cared is that the years of Tom’s harsh coughing has caused such erosion of his trachea that it collapses and he cannot take the amount of air he needs into his lungs. I am enraged at the ongoing neglect demonstrated by the medical profession and by their refusal to help him.

The two primary specialists I tried to reach that Thursday and Friday in November, 2014, both knew the cough suppressant worked for Tom and that he was not a drug abuser. The only thing they had to do was call our local community pharmacy and activate a prescription kept on file for just such emergencies.

Not one doctor instructed his nurse to pick up the phone and place the call that would spare us the ordeal of the ER. I couldn’t allow the coughing to continue. Tom hadn’t eaten in well over a week, he could no longer walk unaided and his breathing was labored. It was obvious, none of Tom’s physicians were willing to help him and his psychiatrist couldn’t.

Here we were with the best health insurance available to anyone in the United States plus eight doctors on Tom’s acute care team and we couldn’t obtain medical care anywhere but the ER. Isn’t this what the so-called Affordable Care Act [Obamacare] was supposed to eliminate? The supporters claimed we would no longer need the ER. Surprise, the writers of the 2,000+ page document need to go back to the drawing board. But, I digress.

Conway, Arkansas Regional Medical Center

Conway, Arkansas Regional Medical Center

Arriving at the ER, Tom was placed in a transport wheelchair, the type without arms. I advised the intake that the transport was a potentially hazardous situation but they ignored me. Their behavior was nothing new. From Tom’s first ER visit all those years ago in 1987, we’ve been treated as if we knew nothing.

A mask covered Tom’s mouth and nose and perspiration gushed from his body. He’d coughed so long and so hard, he’d given up. I’d seen that look

Google Image - Lightweight Wheelchair

Google Image – Lightweight Wheelchair

so many times before. Your face can flat-line the same as your heart.

The five patients in the waiting room appeared as if they had been triaged by the intake nurse. Nothing was happening. Why the long wait?

Crash! Tom’s limp and coughing body tumbled forward out of the transport wheelchair onto the cold tile floor.

Why couldn’t anyone see this was an emergency? This accident should not have happened. I was horrified.

How could emergency room care be worse now than all those years ago when we frequented them due to Tom’s episodes of suicidality?

The answer escaped me that night as my mind raced. How can I help the man I love? I couldn’t take him home. We had nowhere else to go. Nowhere else to turn.

It hit me, it’s not just the doctors ignoring individuals with a mental health diagnosis, it’s everyone in the healthcare industry. Once an individual’s medication list is revealed during intake, the presence of a mental illness is obvious and discrimination begins.

From the moment I checked Tom into the ER on that dreadful night in November, 2014, he was labeled mental. The entire staff overlooked all of his other diagnoses. They didn’t care that his blood sugar was well over 400 because he hadn’t been able to keep a bite of food or liquid down in over a week. They didn’t care that he’d had a stint inserted in June 2014 because his previous heart surgeon neglected to tell us that his left artery was 100% blocked! Had we stayed with that particular surgeon, Tom would have died from what’s called the widow maker – cardiac arrest.

This discriminatory neglect by the medical community has become so severe, it now has a proper name. It is called diagnostic overshadowing.

That night at the ER, I knew we were being relegated to the same treatment that we’d received all those years ago in 1987, when we were seeking psychiatric care for Tom. This night we were seeking medical care but nothing had changed. We were being treated as second class citizens.

Why does this happen over and over?

After 1 and ½ hours we were taken to a treatment room. The nurse asked if Tom could walk. Where did she get that idea? After all, he was in a wheelchair and he’d already fallen once. Where were her eyes? Where was her medical training? Where were her human sensibilities? He didn’t have the strength to stand up.

We were taken to what might have been a storage closet in years gone by. Was Tom’s cough so worrisome they didn’t want other patients concerned about possible diseases on the premises? Unlike every other ER treatment bay we’d experienced, to include this same hospital, the room we were in was nothing like where we were now.

The nurse asked Tom to stand to see how stable he was and again, he collapsed into himself and hit the floor.

Three hours later the nurse returned to take Tom’s vitals. He was shaking so hard she couldn’t get an accurate blood pressure read, heart rate or other simple chart information.

Another hour passed as Tom gasped for every breath. His entire right side was shaking uncontrollably and I’d had enough. I went to the nurses’ station and found Tom’s nurse chatting with an EMT. I said, “I suggest you get the doctor if he wants to see my husband before convulsions take over his body!”

The ER doc was sitting with hands behind his head, kicked back in a swivel chair with feet on what should have been a sterile counter.

How dare he?

Ten minutes or so passed before the doctor made his way to our room. By now our little closet seemed like a holding cell for entry into hell.

The doctor burst into the room as if rushing from another urgent event. I noted his perfectly pressed black wool trousers and monogrammed French cuffs. His shirt, obviously not off the rack, hugged his body under an oh-so spotless and starched long white coat. This doctor was about to go off a 12 hour shift and didn’t have a wrinkle or a hair out of place. He could easily walk into a fashion shoot and be the go-to man for gallant, rakish and debonair.

The physician must have stayed the GQ man of the day by not getting close to his patients. He didn’t approach the narrow gurney my husband had been laying on for over 6 hours.

The doc turned to me and asked, “What do you need?”

“My husband requires the skills of a qualified physician!”

“Then let me phrase it this way,” he said, “What do you want?”

“I want a prescription for Robutussin Cough Syrup with Codeine.”

“What makes you think your husband isn’t having a panic attack?”

I couldn’t believe he had the nerve to ask that question. “I know panic attacks from personal experience and from going through them while Tom fought his own demons. If I’d thought this was a panic attack I have enough medication to treat it at home.”

The doctor didn’t say another word. He wrote the prescription as requested plus one for antibiotics (which we didn’t need) and signed off on Tom’s chart. The ER doc evidently hadn’t read the latest guidelines from the Centers of Disease Control regarding the over prescribing of antibiotics or the warnings from the FDA and various other governmental agencies.

Compliments of Google

Compliments of Google

In keeping with the new 2015 Medicare ruling of measuring quality care, this was the first time we had used Conway Regional Health System and had not receive a survey summary on how well our visit had gone. I found that interesting as we’ve received a survey for routine episodes such as lab procedures and a mammogram since that date.

Once again, thank you for reading with me. Do you have an opinion on why the medical establishment continues to ignore the needs of the mentally ill? Are you hopeful the current medical treatment of those with a medical condition and a mental illness will be equalized?


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Healthcare/Medical 2015/One Woman’s Opinion
by – Sheri de Grom

Continuing rise of health care cost - Getty image.

Continuing rise of health care cost – Getty image.

Statistics regarding our U.S. healthcare system are often alarming and baffling at the same time. Numbers I’ve discovered while researching one topic or another include the following:

  • We’ve created a healthcare system in the U.S. in which 1.5 million people work in the health-insurance industry while less than half as many doctors provide the actual care.
  • America’s total health care bill for 2014 was $3 trillion. That’s more than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia.
Getty Image

Getty Image

  • We spend $17 billion a year on artificial knees and hips, which is 55% more than Hollywood takes in at the box office. All the extra money the U.S. spends often produces substandard care or worse.
  • There are 31.5 MRI machines per 1 million people in the U.S. but just 5.9 per 1 million in the U.K.
  • We spend another $85.9 billion trying to treat back pain, which is as much as we spend on all of our country’s state, city, county and town police forces. Experts say that as much as half of that is unnecessary.
Getty Image

Getty Image

All of these high-tech advances: pacemakers, MRIs, 3-D mammograms, have produced an ironically upside-down healthcare marketplace. It is the only industry in which technological advances have increased costs instead of lowering them.

Healthcare is so hard to fix because it’s our largest industry, employing a sixth of the country’s workforce. Additionally, it’s the average American’s largest single expense, whether paid out of our pocket or through taxes and insurance premiums.

I’m always surprised when I check the numbers and learn the healthcare industry outspends all other interest groups for lobbying. Who would have thought healthcare lobbying would outspend the #2 Beltway Bandit by 4 to 1? Healthcare spends $4 to every $1 the military-industrial complex spends.

It doesn’t matter which population our congress serves. When our chronically dysfunctional politicians decided they wanted to mess with our healthcare, we knew we could bring them to their knees.

Getty image

Getty image

Obamacare gave millions of Americans access to affordable healthcare, or at least protection against being unable to pay for a catastrophic illness or being bankrupted by bills.

But, I ask, what about those of us that had our retirement accounts [accounts not belonging to the government but to the individual] robbed to make subsidies available for those who could not afford to buy insurance?

I’m not happy about this. Not for one minute. Would you want your personal 401k dipped into for a stranger to have insurance?

I’m not in favor of paying subsidies to anyone. I worked hard for my retirement and didn’t receive set-aside monies for my education. There’s been nothing privileged about my education or career success. I worked full-time while earning my college degrees plus took care of a family.

Each time Congress has been unable to fund a program in the last six years, they’ve looked to the federal employee or retired federal employee Getty imageand retired military to make the sacrifice. I don’t have a warm fuzzy when I know others are receiving subsidies for health insurance and my retirement funds are making it possible for them to live a life I don’t have the luxury to live.

The monies being taken are not from social security or medicare. They are not taken from any federal revenue sourced program. These accounts belong to individuals and no one else. We’ve saved monthly from our salaries to secure a safer retirement.

This is one woman’s opinion, but please, if you read this and you’re receiving a subsidy for insurance under Obamacare, think about the fact that I’ve worked 40 years while you are at home with your children or perhaps following another path more to your liking. I’ll be 70 next year and excuse me if I sound harsh when I say to you, pay your own way. I’ve paid for mine, more than once.

As always, thank you for reading with me. I appreciate you and wish you only the best life has to offer.

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Medicare/Medical 2015
by – Sheri de Grom

What are the chances you’ll become an elder orphan? Are you 65 or older, without children and alone?

No one knows exactly how many individuals fall into this newly-created medical care category. The theory is that 25% of all Americans over age 65 are at risk of becoming elder orphans or should already be classified as such.

This vulnerable population already exists, but they have no voice or support system. Elder orphans must have advocates. However, their needs must be defined first.

We do know elder orphans are aging alone, with no known family member or designated surrogate to act on their behalf. It’s imperative we determine which community, social services, emergency responses and educational resources can help them.

This population is growing as society ages and life expectancy increases.

Geriatrics Healthcare Professionals Logo

Geriatrics Healthcare Professionals Logo

The University of Michigan conducted an extensive survey and presented their findings at The American Geriatrics Society’s 2015 Annual Scientific Meeting, May 15-17, 2015. Their conclusion is that without intervention, elder orphans are at the greatest risk of a wide range of negative outcomes that include functional decline, mental health issues and premature death.

This is the population the study fears will utilize the most expensive healthcare resources because they don’t have the ability to access community resources while they’re well but alone.

The 2012 U.S. Census data supports the findings of the increasing number of elder orphans. About 1/3 of all Americans aged 45 to 63 were single, a 50% increase from 1980; nearly 19% of women aged 40 to 44 have no children, as compared to 10% in 1980.

Never leave your animals behind on moving day. Picture - Google

Never leave your animals behind on moving day. Picture – Google

Baby boomers, more than any other generation, have been mobile without much of a backward look. I’ve moved more often than most as part of my career and loved knowing another adventure was always around the corner.

Google - The surviving spouse sees the other through their illness and beyond.

Google – The surviving spouse sees the other through their illness and beyond.

The reality for Tom and me is that someday (probably sooner than we’d like) one of us will be an elder orphan. It doesn’t matter how much pre planning I’ve done, how many extraordinary providers of care I have in place—we’re it. We are a family of two.

Thankfully, we’ve been graced with the most amazing friends and I know they are only a phone call away. They have been there for us time and time again.

How about you, what are your thoughts about this new population of elder orphans? Have you put plans in place to protect your wishes? Is it possible that you could become an elder orphan?

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Mental Health/Bipolar Disorder/Journal Notes
by: Sheri de Grom


My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, "It is never simply a record of daily events."

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, “It is never simply a record of daily events.”

I departed Tom’s hospital room at 10:30 p.m. after his last medication dose for the day. I kissed him goodnight as he stared straight ahead. The light had gone out in his eyes and the shadow of his smile was gone.

What happened to Christmas? What happened to us? Tom and I were meant to be together and now we faced the fourth Christmas IN A ROW with him in the hospital. Please, this couldn’t be our destiny. We were meant to be together, not apart.

I had an uneasy feeling as I left Tom’s room that night. Stillness filled the lengthy corridors. Not a single Christmas decoration could be seen. The silence hung heavy, thick with tension. Were there stifled screams locked inside the lungs of lonely, frightened patients behind closed doors? I’d left the mental health unit several minutes ago but the eeriness lingered.

I normally didn’t allow myself to operate on autopilot, but numbness overtook me. I always reminded my team to never, ever let their guard down. Reprieves were deceptions. The world of those we investigated became completely out of control. We were in the business of turning people’s lives into chaos. They were to take nothing for granted and always be vigilant.

Many prominent citizens along the Central Coast considered our team their personal enemy. A current Veteran Affairs investigation had started simply enough when we’d run a routine paper trail to verify that nursing homes were being paid inappropriately for care provided veterans or not paid at all. The veterans, in turn, were to receive quality care and their pitiful $30 monthly allowance. Little did we know we’d end up with a multi-billion dollar fraud case plus thousands of medical and physical/mental abuse cases on behalf of those veterans.

Getty Image

Getty Image

The Veterans’ Affairs Administration had long passed their ability to manage long term-care patients and they contracted privately-owned nursing homes. Unfortunately, little oversight was built into the program and abuse by both family members and private facilities had reached a shameful crescendo.

Many veteran disability checks were sent to a bank account where the family member had signatory authority. When the check arrived each month, the family didn’t pay the nursing home for care provided or give the veteran the cash allowance that was rightfully his. Instead, the money went to support drug habits, lavish lifestyles, fast cars, or to increase an existing income.

The veterans didn’t know why the nursing home wasn’t being paid nor could they understand why their families weren’t coming to see them. The patients would try to do odd jobs around the facilities to help pay for the occasional haircut and the patients that were able would help care for the ones that were unable to care for themselves.

I was reminded of how easy it would be for Tom to fall prey to a situation where someone was supposed to be watching out for him and greed would take over. I vowed never to put him in such a vulnerable situation. I had to make time to set up a trust for Tom and I couldn’t put it off. Tonight, I didn’t want to think about anything except how Tom and I were going to get our lives back.

The fight had drained out of me today. My legs didn’t want to propel me further and I ached everywhere. I needed a good soak in the hot tub. A massage would be nice too. But, that wasn’t going to happen.

A moment later a long, lean shadow slipped along a curved portion of the central corridor I needed to pass through. Sheri, GET A GRIP! For heaven’s sake, at least fifty people were moving about, what was my problem? When had I become afraid of shadows? And, then the shadow stepped away from the wall and became my deputy, Mike.

“Hey,” I said. “How long have you been here?” I took in a deep breath and tried to stand straighter. My body hurt as if I’d taken a beating.

Mike stepped forward holding his arms open wide and I walked straight into them. I set my briefcase down and wrapped my arms about him. I let out a deep sigh as he closed his arms around me. Tucking my head under his chin I caught the scent I’d become familiar with over the years.

I wanted it to be Tom holding me. I wanted the trace aroma of Tom’s woody aftershave comforting me. Most of all, I wanted Tom promising me everything was going to be okay. But, he hadn’t been able to promise me anything for a very long time.

In a cracked voice, I told Mike, “I can’t take this. Tom’s gone and I don’t know where. I don’t know what to do or who to trust.” Gasping for breath, “I don’t mean you, Mike. I know I can always depend on you.”

“You’ve always got me, boss.”

We sat awhile but I had to get home. It was Christmas Eve after all. Mike knew what Christmas meant to me and his sixth sense had picked up on how fast I was deteriorating.

I couldn’t imagine ever being comfortable in my own skin again. My world continued spinning and I didn’t know how to control it. I had changed along with Tom’s illness. My insides ached as if long fingers had reached in and rearranged my organs. The sensation made me suck in my breath. If only I could turn the clock back. Would I be able to breathe again?

Mike wrapped my cold hands in his warm ones. “Sheri, you’re not alone. I’ll always be here to help you through whatever this damn disease throws your way. You know I’m your friend first and partner second. “

Tom had often teased that Mike and I behaved like an old married couple. In the early years of our working relationship, we’d been together twenty-four/seven. We were both workaholics and our skill levels complemented each other. We knew people talked, but we didn’t care then and we didn’t care now.

Booming thunder met me as I left the hospital that night. Fierce winds and lightning lashed the starless sky. I waited for the Santa driving trolley to take me to my car. I didn’t want Santa, I wanted Tom.

Driving home, I listened to soft jazz on the radio. Again, Kenny G’s soprano sax and his rendition of ‘The Shadow of Your Smile’ haunted me. I wanted Tom’s fun loving smile, not a mere empty shadow.

The raindrops pounded the car. I wondered how high the small brook in front of our house had risen. I was in no mood for hauling out the sandbags.

I wanted to scream or throw something but I was just too damn tired. How much more could I take?

# # #

Rounding the curve of our drive, I pulled the car close to the front door and parked. I wanted to squeeze my eyes shut and crawl inside myself. I wanted calm but it wasn’t happening.

Lightning crackled. The air smothered me. The December storms matched my state of mind. Damn it. I wanted to scream, to rage at the weather gods. I needed the thunder to roll and then . . . I looked down. Farley’s little body trembled. He was without his beloved master. Burying my face in his hair, I let the uncontrollable tears flow. I wanted to promise him that his master would be with us soon and he’d be the man we knew. But, I could make no such promise. Not now and maybe never.

Farley had spent the day at my office, although I wasn’t there. Often when I was going to be away from home all day, I’d drop Farley off at my office and everyone would pamper him the entire day. He always knew he could go from office to office and steal cheerios from desk drawers and then return to Mike’s office to sleep in his basket. Mike loved to pretend he didn’t like little fuzzy dogs but oh, what a fun relationship they had. When Farley saw Mike approaching, he’d take off running and fly into his arms.

It was only natural that Mike turned Farley over to me at the hospital. After all, he was a member of my family.

Looking toward our house a shiver ran down my spine. The front door hung wide open. Black terror enveloped me. Had I forgotten to close the door in my haste to get Tom to the hospital? Again I shuddered at the thought.

I grabbed my trench coat and bundled Farley in it. Tossing my heels in the back, I held Farley close and, barefoot, sprinted across the drive, up the slippery stone steps and into the house.

Setting Farley down and after today’s events, I defied anyone to push me further. Infuriated with myself, I moved through the house, moving back and forth, and sweeping from side to side as I moved from room to room. Shadows crept in from outdoor lighting allowing me to see. Satisfied that I had left the front door open, I flipped the three light switches just inside the door and the entire house and outlying property lit up.

Morti, my twenty-two year old tabby, meowed with force. I must have left the door open, but had I? Morti didn’t like change; I’d missed his dinner hour and the house was cold.

I wished I could change into comfy sweats but I had to feed the cat or he’d never quiet down. I gathered all twenty-five pounds of orange fur into my arms. He responded to the attention by purring as loud as some freight engines I’d heard. I clung to his warmth and comfort.

“Hey, Morti. How are you?”

He looked at me as if to say, now what do you think?” He opened his mouth and I expected a howl but once I opened his cat food, he had no time for idle chatter. Pouring his daily allowance of whipping cream in a china saucer, I thought he’d be content. No such luck. Perhaps when I had a fire going he’d relax.

Farley hadn’t eaten either, but he had the patiences of a saint. I poured food for him, changed the water bowls and headed off to build a fire. Dry wood stood by the fireplace. Tom had always taken care of this task, but in the past few months, I’d been forced into chores he’d once performed.

Morti still fussed in the kitchen, but I couldn’t take care of anything else for another minute. I was beat. The house echoed with the despair I felt. Tom wasn’t home and I didn’t know when he would be. Each hospitalization seemed to take him further away from me.   

Falling in love with Tom had changed my life. I no longer wanted to be the fiercely independent woman who cherished being alone and answering to no one. Would I have to go back to being that woman? I didn’t like change any more than Morti did.

Roaming through the house, overwhelming sadness cloaked me. My mind slid backward in time. I dropped to the flokati rug in front of the fireplace and watched the shadows of the flames dance on the ceiling. Christmas decorations glittered throughout the house, the pounding rain on the roof soothed my shattered soul and I drifted back in time. Effortless, considering today’s events . . .

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Mental Health/Slice of Life/Journal Notes
by – Sheri de Grom

Notes From My Journal – Monterey, California
Continuation of Same Night, Late 1990s

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said,

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, “It is never simply a record of daily events.”

The dash clock reflected twelve forty-five a.m. by the time I pulled into the hospital parking lot. My body was starving for air; I needed sleep. It hadn’t helped that my day had been blown out of the water. Nothing had gone as planned.

The time spent with my deputy, Mike, had rejuvenated me. If I had to have a meltdown, at least Mike understood me.

Tom would be asleep but I desperately needed to connect with him, to see him, to touch

Logo for those of us dedicating much of our lives toward advocacy on behalf of the mentally ill.

Logo for those of us dedicating much of our lives toward advocacy on behalf of the mentally ill.

him and it would be sheer delight to see a smile or feel the touch of his hand.

I’d never missed anyone or anything as much as I missed Tom. My heart may as well have been stomped on. I was having a difficult time coping without my mate.

I so wanted to discuss my office challenges but my always-brilliant strategist had disappeared into a drug-induced sleep.

Restless Sleeper

Restless Sleeper

His ragged breath told me his body struggled against an overload of drugs. He’d always been a relaxed sleeper—or he had been before the demons took over.

Some days I never saw Tom awake, either at home or in the hospital. I couldn’t wait for a new life to miraculously appear while he slept. Too many people depended on me. If something positive was to come of the base closing, I had to make it happen. I’d made life-altering decisions before without his input. But, damn it, I wanted my life partner and he was gone.

I stayed an hour and watched Tom sleep. I didn’t wake him. What was the use? I was afraid he might have problems getting back to sleep.

I wanted to strip and get into bed with him . . . but hospital rules were hospital rules and I pushed the bar by being there outside regular visiting hours.

Leaving the hospital at two a.m., I drove the final leg of the trip home. The Christmas lights reflecting off Monterey Bay were magnificent but tonight I was battle-scarred. I could be summed up with one word—desperate. My pain was overwhelming. I needed to feel something other than profound grief.

Monterey Bay Pier

Monterey Bay Pier

I knew my depression was getting worse and that changes had to be made if we were going to survive Tom’s illness. There was no predicting one day to the next. One moment we’d be riding a wild wave of mania. Then the ocean wall holding back that last tremendous crashing wave would break loose and the sinister, dark despair of depression would suddenly slide downward, and all light or hope disappeared.

I wanted to believe normality would return when Tom had energy-charged days with many things happening simultaneously. More often than not, these days were actually the precursor to mania. Each manic phase produced another artistic masterpiece or a broken promise. This could be the spontaneous fun-loving man I remembered. More often, it was not.

I’d experienced that big build-up many times. I reminded myself it was the disease but sometimes it felt downright selfish. Bipolar disorder became a third person in our marriage and I had to find a way to keep it from destroying us.

I’d read that 90% of all marriages where one partner is bipolar ends in divorce. I was not willing for us to become a number in that statistic. Tom and I would survive. Love would show us the way.

Traffic crawled and the road was especially dark. Normally the drive home was pretty at any time of day, but tonight it was just plain black.

I could see our lights in the distance. I wanted to find Farley and Morti and climb into bed, but I still had multiple chores. Final Christmas touches waited, holiday staff bonus awards and recommendations for payments needed to be written for the government Civilian Personnel Office and the list seemed endless.

I found Catherine, Josh (Tom’s apprentice) and other members of my team on the outdoor patio near the fireplace. Catherine had made snacks and hot chocolate for everyone and even Farley was enjoying the festivities.

I didn’t have the energy to get my briefcase out of the car. I looked down to pick up a folder of papers and spotted my wallet. How careless of me. It must have fallen out of my purse.

“Look who’s here,” Catherine said. “Was she surprised to see me?” Wrapping my arm around her waist, my heart lightened. She bounced on her toes and swayed to the Christmas music. I remembered earlier antics that day discussing the Christmas party and smiled.

“Thanks for holding down the fort. I’m almost asleep on my feet. I have to go to bed.”

“Of course, we’ll clean up here.”

“Come on Farley, let’s go to bed. This has been one long day. I bet that Morti cat has already claimed a pillow.”

I tossed today’s mail on the table; my eyes were too tired to read. I couldn’t think; it was too scary.

The above is the continuation of a normal day for me after Tom was diagnosed in Monterey and I worked on Fort Ord. If it hadn’t been for my best friend, Catherine and the team I worked with, I cannot imagine how I might have survived those days and nights of living and learning about mental illness.

Thank you for reading with me. Your thoughts are always appreciated.

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Mental Health/Journal Notes/Slice of Life
by:  Sheri de Grom

Notes From My Journal – Monterey, California
Late 1990s

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said,

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, “It is never simply a record of daily events.”

My office on Fort Ord was quieter than usual: no laughter, chatter or copy machines running. Usually the investigators bantered with each other and the phones never stopped ringing. When had the silence settled in? Had another day passed me by?

Glancing up from my stack of folders, I saw Mike, my deputy, standing in my office doorway. He hadn’t made a sound; one of his unique qualities that always amazed me. I marvel at his ability to hold one pose motionless for hours on end. He’d told me it was a talent he’d honed along with his sharpshooter skills. He’d never shared with me exactly when he’d needed that expertise and I hadn’t asked. We’d shared the shooting range often enough to know that we could cover each other with confidence.

“Hey you, how long have you been standing there?”

“Long enough to know that we both have to get out of here. It’s almost nine-thirty and I heard you tell Cecelia [editorial note – my secretary] earlier that you were still going to the hospital tonight. I know for a fact that you haven’t had anything to eat in several hours, if at all today.”

Leave it to Mike to call it the way he saw it.

“And what have you eaten today?”

“Remember, I had that delicious lunch at the nursing home.” His body tensed and his hand grazed his belt as if the memory were physically painful. “I hope I live long enough on their food to finish the investigation.”

“We’ve seen the winning results of those meals haven’t we?” Mike went on to tell me how the patients’ lunches had consisted of chili dogs, potato chips, cooked cabbage and peaches in heavy syrup. Every tray the same. No allowances were made for diabetic or other medical nutritive needs and the high sodium content alone made the entire meal unacceptable. The indigestible component of the food for the patient population being served broke every rule.

Nursing home fraud routinely uncovers massive irregularities concerning patient nutrition. Thousands of dollars are saved annually by ignoring Federal guidelines.

We’d started our investigation as a Veterans Affairs fraud case but fraud opened up wherever we turned at the nursing home. We had no idea where this case was taking us, but it wasn’t going to be pretty. Every item we examined revealed additional improprieties.

“What do you say boss, let’s get out of here and go grab dinner.”

“I’d love to but I really must go the hospital.” The internist promised she’d keep me informed, but that’s not enough. How can I say Tom is my top priority when I’d admitted him that morning and hadn’t visited or called all day?

Suddenly I felt weird, the all-too familiar and uncontrollable perspiration running from every pore, and makeup slithering down my face. My hair was oily and wet and so was every inch of my body. Did I smell? My clothes stuck to me.

I couldn’t pull enough air into my lungs, my breath quickened but air came raw into my throat. Suffocating. There was that sensation of a trapdoor suddenly opening in my belly. Oh, God. Please don’t let me soil myself. My heart wanted to jump out of my chest . . . I was sure it could . . . it would . . . that was my heartbeat roaring in my ears, wasn’t it? It was uncomfortable to swallow; the perspiration intolerable.

I’d always worked hard to maintain my image—a professional woman. Could this be God’s way of saying, the joke’s on you? Was it my fault that Tom suffered?

My hands tingled and then they didn’t. Why couldn’t I feel anything? Had I lost touch with reality?

“Sheri, Sheri . . . can you hear me . . . it’s Mike. You’re here with me and you’re safe.”

I felt a hand on my arm and jerked.

“Don’t touch me. I feel so grungy.” I cringed. “I’ll never be clean. I need a shower.”

My legs folded under me. I wanted to stand, but couldn’t. Touching my lips, the tips of my fingers were wet. Blood. I’d bitten my lips so hard they bled.

“Sheri, breathe. Come on, deep breaths. Follow me. In-out. That’s it, now repeat. Over and over.”

I was calming down. My heartbeat was slowing. But I was still covered in sweat. The worst feeling ever.

I lay on my office floor; how could I compose myself after what had just happened? Even more puzzling, what had just happened?

Mike bent down and supported me while I stood up.

“Boss lady, you’ve given me one hell of a scare. We’re not going to do whatever that was again. I’m going to play Dr. Mike for the duration of the VA case plus all the other stuff you have going. You need a good meal and a way to blow off steam so you can focus on whatever you think you must do.”

“That’s quite a speech, partner.”

“Indeed it is. Now, if you like, you mentioned feeling dirty. I don’t see you that way but if you insist, I’ll give you time for a shower before we eat. However, don’t plan on my being so lenient in the future.”

“Yes, sir. Might I ask who made you the boss of me?”

“I thought that was pretty obvious. You asked God for help and I’m here. You know, our Lord does work in mysterious ways.”

“Don’t be a smart-ass.”

But in my mind, I was thanking God for this particular smart-ass.

“Go get your shower and no you don’t have time for makeup and all that girly stuff. I’ll pop us a couple potatoes in the microwave while you’re doing your thing.”

Standing on tiptoe and leaning in, I warned, “Don’t you touch me.”

Mike’s mischievous grin and flashing blue eyes were music to my seriously bruised and battered heart; I planted a kiss on his forehead.

One of the best features of having our offices in an old WWII barracks building was that plumbing was in place. No one had ever thought to take out the toilet and shower between each office. My theory was simple. I was a workaholic and I wanted some comforts of home. My shower connected to my office; how convenient is that?

I didn’t know what had happened to me earlier but I did know that I’d lost it and was sure that it was a result of trying to hold everything together and pretend I was coping, when in fact, I was falling apart.

I was sacrificing myself for everyone else and I didn’t need anyone telling me how that would turn out if I kept up my current pace.

Clean skin, clean hair . . . nothing in the entire world felt better . . . wel . l . l . not unless I could slip into a bed with crisp, clean sheets with Tom. But, that was a fantasy.

Pulling on favorite faded jeans and an old familiar flannel shirt brought a smile to my heart.

Lord, it was good to touch something as simple as a well-loved flannel shirt and have it fill my heart with pleasure.

I found a pair of socks to match my shirt and padded without shoes into Mike’s office.

“Wow, you’ve gone all out.”

His office had become a quiet library setting. He’d moved his lamps to softly accent the walls of books. They cast a glow across his leather-bound collector editions with their scripted gold lettering along the spine, soft jazz played in the background.

“This is wonderful. You’ve even rolled your sleeves exactly the way I love them.”

The staff was always teasing us about my preference for the sexy way Mike had of rolling up his sleeves. He had a special way of doing them that was a real turn-on, to me anyway. Tom had tried to duplicate Mike’s method numerous times and had even tried to get Mike to demonstrate his skill. Mike liked to tell Tom that it was the only thing he could do better than him and he wasn’t about to give away his one winner.

“This is so good and so much better than going out.”

“I agree.”

We’d laughed often calling the refrigerator in our personal supply closet our best secret weapon, and tonight it was proving itself just that. He’d prepared a wonderful assortment of the goodies that Cecelia kept stocked for us.

In the hour that followed, the conversation flowed easily. Mike exuded confidence and charisma. From time to time he allowed a smile into his voice as he shared his concern about how hard I was pushing myself. Those sharp, clear eyes of his told me he knew he was right on target. He’d seen me move into meltdown mode less than two hours ago.

“Thanks for dinner but I absolutely must get to the hospital. I can’t go home until I see Tom.”

“Why don’t you let me drive you to the hospital? I worry about you when you’re so tired.”

“Thanks, I appreciate the offer. But, I can make it on my own tonight. Thanks for the wonderful dinner and I’ll see you tomorrow.” I remembered a song we’d tagged as ours and laughed, “By the way, I’ve Had The Time Of My Life. I always do.”

ADDED NOTE: I have no idea how I would have had a successful career if I hadn’t surrounded myself with highly-motivated people who have become friends for life. During the many years we worked together as a team, I often thought they knew me better than I knew myself.

Names have been changed but my heart sings when I remember my friend, ‘Mike.’

How about you, have friends held you up when otherwise you might have fallen apart?

I’ve had many panic attacks like the one I describe in this blog. In my situation, they are triggered by my PTSD.

Thank you for reading with me.

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