Everyday Disappointments of Living in the Medicaid Gap

There are myriad downfalls to having a long-term injury. There are big worries, like providing enough income to support my children, keep a roof over our heads, or pay the power bill. There are things like pain management and being so very, very careful with each and every single step and movement lest I destroy any progress I make in trying rehabilitate a knee with information gleaned from Dr. Internet. There are the little things too. Those activities that celebrate living and make life better. 

I bemoaned my complete, all-encompassing disappointment to my husband yesterday as I sat down to take a break after ironing my work clothes. This time it was the disappointment that ironing -- a chore I once enjoyed -- wore me out. The work of attending to laundry has exponentially expanded although the amount of clothing and the goal remains the same. Performing elaborate rituals with dysfunctional appliances while in constant pain is just frustrating. 

I read the stocking schedule for the local waters in the newspaper. I hobble as I wander to the garage to look over my collection of gear that has accumulated over several lifetimes -- the legacy of gone family members and friends, collected and waiting for me to pass the long-honored tradition to my children. Its a tradition I relish. Its a tradition I miss. The logistics of trying to get myself and gear to water's edge and fish are complicated, even for some of the simpler waters in the area. 

I wonder when I'll hear the swish of the rod whispering above my ear as I try to place a feathery fly in just the right place again. I wonder when I'll once again feel the solid click of the 30-year-old Mitchell reel that is a smooth as the day it was made. I take my husband's micro ugly stick off the wall and once again compare it to my own micro, thinking the thoughts of a person mildly obsessed, 'I really like the play in his, perhaps I should get one like it.' 

 I consider setting up a table and making sure all of the reels are oiled and the lures organized by species and colors. Or maybe I should ties some hooks and leader so when we take the kids fishing again we can quickly replace lost hooks at the swivel instead of wasting fishing time with it. 

I turn and go back into the house. I won't go fishing until I can walk again without worry. 

Camping -- no. Hiking, or even just a walk around the neighborhood -- no. Any changes to the yard -- no. Gardening -- maybe, if the family is willing to do the work all season long. But the senses of accomplishment, peace and pleasure in actually working and growing a garden won't be mine. I'll have to rely on others to do the majority of the work. It will become an unpleasant chore for them and one more thing to feel bad about nagging over for me.

So many things that depend on a strength and ability I no longer have. The familiar "if only..." starts in my head, but its a useless refrain and it won't change my life back to what it once was.

Cynic Shaming, or When Optimists Attack

It started with an article about cynicism in the church. I read it, then searched the source paired with the word cynical only to find that this outlet frequently publishes articles against cynicism and pessimism. I wonder about writers exhorting the reader to abandon cynicism and turn away from their pessimist attitudes. Do they understand what brings on such an outlook? There is so much that goes into becoming harshly cynical, that shaming articles and dire warnings that pessimism causes dementia mean nothing.

My husband and I have never been accused of being positive or optimists. We've bordered on cynical and pessimistic for as long as we've known one another and our particular brands of sarcasm drew us together so many years ago. As teenagers we honed our cynicism in church groups while discovering the world was kind only to the privileged and wealthy, unless you could offer something else valuable to the group. Sometimes the only thing you had to offer was the bad example, which we were. The long term relationship spanning high school was supposedly doomed to failure within a year of marriage.  Our near 22 years might be a disappointment to some. I'm guessing by now they've all easily forgotten their condemnation of us, but we haven't.  When church leaders condemn you, it leaves a lasting impression.

Don't get me wrong, we had optimistic times. There were times when we even had enough of our own hope to support others in their hard times. We had fellowship and support, and thus we could offer the same. We had enough to offer hospitality and encouragement. Because we had support, we could offer the same to others. But support and fellowship don't have long-lasting effects once they stop. When we moved to a different state we once again had to try to carve out a place in a harsh new town.

Its hard to maintain optimism in life when scant few friends remain by your side during difficult times. You fear draining any hope they might have with your own distress. Especially if you know that what you face isn't within their circle of understanding. These hard times are when you find out who cares enough to offer support and friendship and who is suddenly too busy to stand with you through the challenges. Its when you become more and more cynical as you see just how little you meant to your community.

I wonder if the people who condemn the pessimist and the cynic understand that they are part of the problem. Instead of condemnation, its time to offer something useful. Instead of shaming people into abandoning their cynical nature, perhaps its time to offer friendship and support. You can never undo what your friends have seen or experienced, but you can show that you care enough to stand by them.

Homeless or Pain

It's late, or maybe early depending on how you look at it. I lie in bed wishing the cocktail of NSAIDs would at least take the edge off the pain in my leg and back enough that I could win the fight for sleep. But like so many nights, pain is winning out over much needed sleep.

As I try to visualize pain receding, think positive thoughts and pray for relief, my mind replays the conversation I had with a friend earlier in the day. We talked about how the Medicaid gap affects my family. Now, many hours later, I wish I had told her the most simplified version: I have to choose between homelessness or pain. I have a family. I have no choice but to live in pain.

Our mortgage lender extended us a hardship forbearance that allows us to pay a minimal amount while we struggle to get back on our feet. In exchange, we must not modify the house or let it fall into disrepair.  We must live in the house and take care of it. We also may not authorize any liens against the property. If we fail to meet these conditions, the lender will fast track foreclosure proceedings and we will lose our home.

The county places a lien against any real property a person possesses if she receives help to pay for medical costs through indigent services. St. Luke's, the medical system in our area, also places a lien against property if a person applies for charity aid. This information is found on both the paperwork and the websites.

So on nights like tonight when the mix of medications doesn't make a difference, I get out of bed and sit in the dark living room of my home--miserable, but not homeless.

Putting Hope in its Place

You can't allow yourself too much hope or happiness when you live in poverty. The idea things might get better is ludicrous, and to forget this is dangerous. There is always something demanding your resources and reminding you that you are certainly no better than you ought to be. There is always something that makes sure you stay right where you belong.  If you live this life, then you belong at the bottom. If you dare forget, than you will be reminded.

Unfortunately, this isn't just an adult thing.  I see this in my kids' interactions with their acquaintances.  Any small spark of joy is quickly extinguished by kids who know that money does buy happiness and friends. Poor kids who work hard are derided by peers until they are securely left with no illusion of worth or value. To train or study hard, to invest time because they do not have the ability to invest money is nothing, because as kids living in poverty, they are nothing. They have no hope of winning friends because they have worked hard.  They can only see that their peers despise them all the more when a leader or teacher draws attention to the results of their efforts.

So we put little hopes and accomplishments away. There isn't room for them in the daily life of scrabbling to survive. We teach our children to do the same.  Because hope and happiness isn't for the poor.  And hard work just means we think we might deserve something more than what we have.

A Slow Start

As spring takes hold of southern Idaho, life is off to a slow start. We've been given a small pickup to help ease the strain of being a busy one car family.  The minivan has proven to be yet another poor option in our descent into poverty. Perhaps the gift-pickup will help us buy more time until we can afford to repair or replace the van.  Count it as another way businesses prey on the poor. If a car dealer can sell a faulty vehicle to someone who is desperate, he will. There is little recourse for an impoverished buyer in this case. We do not have the money to invest in repairs, nor do we have the money to replace the vehicle.

Now that we have a small, steady income, I am starting to set goals again.  We desperately need to replace the washer and dryer as neither appliance works. We cannot consider shopping for new, but the fear of buying yet another broken down, piece of trash discourages me. Dragging the red wagon filled with dripping wet laundry across the yard to the clothes line discourages me too.  I haven't decided which is worse: the possibility of wasting what little money we live on, or dealing with the incredibly dysfunctional, yet known, appliances. These sort of decisions annoy me in their bizarre complexity.  In the past, I would have bought new appliances, complained that my spring was ruined by the cost and inconvenience and paid someone to deliver and install new ones for me. Now I send text messages to craigslist people who never answer back, and wish for the days of the harvest gold Maytag set my, and everyone else's, mother used to have.

In the end, the reality of trying to climb out of this pit is still discouraging as another season arrives. We want to have hope and we continue to try to change our situation, but sometimes... its just so damn frustrating.