Love Old Town Ft Collins!

So as my birthday approached I felt like I very much wanted to take a little road trip by myself. I planned either a spiritual retreat at the Shambhala Mountain Center (no, I am not Buddhist, but they had a retreat for people with chronic illnesses and stress management) or a leisurely trip to the western slope of Colorado to spend a couple of days with my in-laws at their home also known as Casa Rosa and then visit a dear friend who moved to New Castle.

But alas, money,timing and an oral surgery (not me, the youngest in the family) lead to an unfortunate bout of sensibility.

So I took my 2 paid days off and took care of said kid and said oral surgery, then had today. So I have spent my day in Old Town.

Great things:
There is free wireless internet provided by FRII in the downtown area, and if you are in a place with spotty coverage, they likely have their own you can hop on! (Hence, I am writing this in Spoons, eating a grilled cheese and a cup of butternut/potato soup)

The Bean Cycleis our families favorite coffee shop. Great atmosphere, and it is home to the Matter Bookstore, a place to find local authors, alternative publications, and lots of groovy new and used books

New On-Street Bike Racks in Old Town Fort Collins

The City of Fort Collins (in partnership with New Belgium Brewing) is installing on-street bike parking in Old Town. Hooray! More details here. This is awesome. Personally I try to obey the rule about not riding my bike on Old Town sidewalks, but when there's heavy car traffic and light to no foot traffic, it makes you wonder why you're pushing your bike instead of riding it. The on-street bike parking plan supposedly will improve bicycle traffic on the streets too, which in that area can be somewhat risky for bikers.

A time to grow

I am feeling every bit of spring this year. My chronic illness always unwinds a bit as it warms up, the barometric pressure changes, and the sun is shining more. Life is blooming inside and outside of us all.

I couldn't wait to dig into the garden. Last year was the first time I gardened seriously and successfully. We worked for a couple of weeks to remove the sod, turn the soil and add our compost. (we compost with a traditional outside pile as well as a worm bin that spent the winter in the basement). We placed stepping stones amongst the plants so we would not have to step on the soil and compress it.

So as I sat on the walkway and dug what I could reach easily with a hand hoe the soil turned so easily that I felt victorious about my efforts last year. I have not yet dug into the side of the compost bin to see what has become compost over the winter, but the leaves and plant remains we left on the garden area seems to have composted a bit on its own.

So, I planted a small area (probably 3 feet by 5 feet?) with some of the seeds that do well in chilly ground and very early spring conditions. I have never planted anything before Mother's day, and was shocked to find out that I could do so! It was visiting with a person from a local group called home grown food that clued me in to this miraculous truth! In fact, we should be nibbling a few things from our garden at the point I typically would be begging the kids to help me dig and plant.

So currently in the garden is spinach, pok choy, chard, carrots and a lettuce mixture. I can't wait to see sprouts peeking through the garden, though we had to shoo our cat out of there because the freshly turned soil must look like an inviting litter box. Hopefully some of my seeds will have a chance.

I was just reading this morning that the Obama family has decided to plant a garden on the south lawn of the White House! I find this to be really exciting, as they have a chance to inspire others to get their fingers dirty, to enjoy the treasure fresh food is, and to deomstrate the idea of keeping your food local.

So what are you growing this year?

Now a food co-op member

The title says it all. I went today over lunch to the Fort Collins Food Co-Op and became a member. 

Membership costs $20 annually. Each month on the day of my choosing, I get 10% off my total purchase. Also on the 5th of each month, members get 5% off. It's pretty obvious that my $20 is going to be recouped pretty quickly if I do any quantity of shopping there.

Truth be told, that's probably not going to save me a ton of money. (We'll see.) The selection is of course not nearly as wide as a regular grocery store, so we'll still have to visit other grocery stores. However, there are other perks. The location is extremely convenient for me -- I can bike there for my small purchases either from home or work quite quickly. I'm supporting a member-owned, local business. I'm supporting another outlet for quality food products, food & health education, and locally grown food. The selection and quality of the bulk bin items are particularly fantastic. 

But what really intrigues me is the members' special order program. I can special order a large quantity (say, a case or a 24 pound bag of something) and get it for just a bit above cost. I can save an average of 20% off the shelf price for that item. You can see how useful this can be! (Especially for my Ginger Soother addiction.)

I'm sure some readers are asking themselves, "What took you so long?" Yeah, I know, joining a food co-op is a pretty basic step. I'm not quite sure why I put it off for this long, except to say that in the past, when I've visited the store, I didn't see it as cost-effective and I was much more concerned about cost at that point. (I was in a different place financially and health-conscious-wise.) Now, though... I am glad to be a member.

The most important blog entry to date

I just have to show off the babies!
Truly, I have to say that they don't have a whole lot of personality differences yet, or maybe I have just not sat watching them long enough.







I have been trying to let them get used to my hands, and holding some each day, but honestly, you can't really "play"with baby chickens, or can you?





There is one dark colored chick (I really need to have my friend/neighbor remind me what breeds they are) who is larger than the rest, and is quite protective of them all. Other than that, well they are just cute. That's all, but that's enough. as you can tell by the captivating images, their activities seem to revolve around eating, huddling together, and pooping.







I am sure they drink too, but it appears that the other activities are much higher priority. I tried to get one funny shot of a chick that fell asleep with its neck all stretched out and its bum on top of another, but of course some of the passion is lost through the lens. (that is the top right photo in this stunning photo essay)




I am most enchanted by the chicks with the great poof of feathers on top of their heads. When they are full grown that pouf of feathers will cover their eyes, making them pretty vulnerable to predators.

So there you have it, baby chicks! ahhhhhhhhhhh

Overspending and a broken system

I had officially marked this space with a specific train of thought forming to fill it, but that thought has grown much too big to be contained in one post. In the pondering of such subjects, I came to another point at which to begin making a case for changes in the health care system. (yes, yet another case for this necessary change. I know that the need is not at all disputed, but my hope is to add yet another face to the crisis)

As an employee of a community health care system, one of the benefits in place to make the lower than average pay and overwhelming working conditions more palatable is free health care for my family. Well, it is free to see a provider in our clinic, as they do not bill the difference between what our insurance reimburses and what the clinic charges. We also are able to use one of the dental clinics in our system at a very large discount.

Our youngest family member seems to have some very unique characteristics, one of which is an extra "tooth" that is coming in between his two front teeth. This small tooth piece (I think it is smaller than a baby tooth) is causing his two front adult teeth (on the top) to come in turned 90 degrees from the normal position, which has obvious ramifications.

The dental clinic associated with my employer does not do extractions on children of this sort. I think that they may not do any extractions on un-erupted teeth.

Because most/all of the children who are seen in this clinic are covered under Medicaid or CHP+ (the option for families who make too much for Medicaid coverage but are not able to provide insurance for their children) the standard to to refer them to the dental clinic at The Children's Hospital. It is also ideal to have a child undergoing sedation for a procedure to be cared for by someone who specializes in the care of children.

We think very highly of this clinic(and the hospital) and were eager to return and let them take care of our "funny tooth" problem. I called TCH to make an appointment for a consultation, and was told that because we do not have Medicaid or CHP+, I had to speak to a financial counselor and make arrangements ahead of time.

When I was transferred to the financial "counselor", I was told that they have created a special "Dental Package" for families who will be paying out of pocket for the sedated dental procedure. The Anesthesiologist, the hospital fee and costs of using the surgical facilities is conveniently lumped into a discount package, and then the cost of the actual dental work will be in addition.

The cost of that dental package is $2500, with a down payment of $1000 required on the day of the procedure, and the balance payable over a 24 month period interest free.
Shockingly, I almost had a nervous breakdown, knowing that it would be all but impossible for us to pull together $1000 dollars in a timely manner. This procedure needs to be done as soon as possible in order for the remaining teeth to have a chance to straighten out at all on their own.

As I fought a panic attack and feelings of total inadequacy at taking care of my son, I rationally thought of calling another dentist to see if they would be able to do the procedure in office, or at least in town instead of in the Denver area.

We had a very good experience with a pediatric dentist in town (Dr VanTassell) so I scheduled a consultation appointment for the following week.

Much to our relief, he can not only take care of the procedure in his office, he suspects it will only take approximately 15 minutes under local anesthesia! Oh, and the cost? Somewhere between $125 and $350, depending on how easily the funny tooth is removed.

Which leads to the next shocking question: why should Medicaid or CHP+ pay significantly higher costs for the same procedure? Families who are helped by these programs are not in a position to look for a cheaper price, nor would they need to. All costs are covered. I know that in the past when our children were on CHP+, it never occurred to me to find out what the cost would be up front. Of course it would be discounted or at least a fair price. Isn't that part of being a participating provider?

So, start thinking in numbers. The minimum price for 10 children to have dental procedures done under sedation would be $25,000. 10 procedures that could potentially only cost $3000 dollars if done in a non-hospital setting.

Or to break down differently, the 25,000 used to care for the 10 children in a hospital based dental clinic could provide the same care to 83 children outside of a hospital.

So, start pondering numbers on an even larger scale. Millions of individuals covered under our current system, having millions of procedures, millions of care choices. What if we were to revamp the system so that the dollars we spend are used in a more frugal way? What if providers were required to bid for procedures, provide the most comprehensive yet penny saving services in order to become a qualified provider?

I know that what we hear of most (what I live with day to day) is the low reimbursement rates for primary care providers and specialists who care for the low income Americans. Many clinics are forced to limit or eliminate the number of patients they include in their practice due to the very slow or unfairly low rates of reimbursement.

What would a national health care plan look like in which providers who offer preventive care are reimbursed at a competitive rate, and procedures must be bid for like a contractor working for a government agency. How many more people could we provide basic health care to if the fat was trimmed, and there was adequate reimbursement for the key providers who keep patients healthy?

One thought: If the average hospital vaginal birth with no complications costs $7000-10,000 (this does not include the cost of prenatal care, it is only the hospital bill for the birth), and the average cost of a homebirth (in Colorado) is $3000-$5000 (including all prenatal and post partum care, and newborn care for baby), wouldn't it make sense for Medicaid to support it as an alternative for healthy women who have no risks, and wish to have a homebirth?

I know that the jump from dental care to homebirth seems sudden, but you will learn that for me, everything can be related back to birth. The suggestion of homebirth likely evokes emotions in the reader ranging from "wow, are there still homebirthing hippies around?" to "who would be insane enough to have a baby at home, what if something goes wrong?"

Each of those questions will be addressed in a later posting. I just encourage you to think about the dollar amount related to covering those currently included in national health care dollars, and how those dollars can be better economized to make sure all American's are able to count on basic health care. It is just not something we can afford to go without.

Chickens!

I want to announce that my dream of having my own little flock of chickens has come true! My wonderful neighbor and friend took me to pick out my birthday gifts this morning. I chose 6 cute little chicks of varying breeds!

We will be celebrating my birthday with the extended family in 2 weeks, to build our chicken coop in the back yard. Until then my cute little babies are staying with my neighbors chicks in her coop, in a large aquarium with bedding and a heat lamp until it is a bit warmer, they are a bit bigger, and my coop is finished.

I am so excited to have the beginning of my small urban homestead tucked on the edge of city limits. We are expanding our garden significantly this year, hoping to be able to provide more of our own food. We will dry more, can and preserve a bit more this year, and make good use of the space we have. With our own chickens helping to scratch up the ground, eat bugs, eat some scraps and give us eggs(which we hope to start enjoying in August) that adds to our own little sustainable unit here.

I always believed that I was very limited in my ability to provide much of our own food by the space we have here in our yard. Then I found Path To Freedom, the inspiring story of a family in California who have not only been able to become self sufficent,they also grow enough to provide local restaurants with organically grown vegetables. I know that they have the benefit of a more moderate climate with a year round growing season, but surely I can do much more on my own property than I have ever imagined.

So what do you imagine in your little world? Can you grow salad greens in a container inside your kitchen window if you are an apartment dweller, or can you put a tomato plant in a pot on your deck? do you have a section of your yard you always pondered making into a garden but have been intimidated by? Or have you also had chicken dreams?

Lets all aim to make our own little homestead of all sizes. We will be less dependent on food that is trucked in from other parts of the country, other parts of the world. Less fuel, more fresh air and sustainability.

Or, if you can't yet start your own sized homestead, then go local. Join a CSA, shop at the Farmers Market to support local agriculture.We can all make changes, large and small, towards creating a new system that makes more sense, that will help us all works towards changing our habits.

The big day

So here it is, another year. Though really, I feel the same as yesterday. It has been a wonderful day though. I did choose to work, and take my paid day off in a couple of weeks with a weekend and a floating holiday. Thanks for the messages of love from so many.

I have to say it is a little funny to call mom and start to tell her something, and her say "Oh, I read the blog!" Well, Hi Mom!

I want to address healthcare. I know this is my pet issue, because I am a consumer (well, isn't everyone? But I am a serious consumer, with a chronic illness) as well as part of the health care system.

It is broken. it is heartbreakingly broken.

Today I helped prepare a woman for a casting of the wrist she broke 2 weeks ago. She was seen then in the ER.They only splinted it, and sent her to her "Primary Care Provider" for the casting. I imagine they wanted wait until after swelling went down a bit.(I want to believe that was the reason, and not a lack of desire to provider additional services that would not be paid for. Surely, but I imagine that sort of passing the buck is not uncommon in the nation when hospitals are being swamped by the needs of the uninsured, the poor, the weary)

The idea, the expectation of her having a primary care provider is ridiculous. She is homeless, transiently passing through town, wanting to head out on her "adventure" as soon as she can. She was told to call my clinic, because we are the net that catches the falling souls. Unfortunately we only have so much room in our net.

We are fighting a huge flu outbreak, along with a wicked virus. Each day we are sending established patients to the ER or Urgent care because we just can't see any more patients. You have to understand that most Dr's offices see 20 or so patients a day, give or take a few. The Dr's in my clinic see between 28 and 32.(In fact I know of one wonderful pediatrician who managed to get 19 very sick children through his rooms in just the morning, because he had to attend meetings in the afternoon) We are seeing as many people as physically possible, and we can barely keep up with that many. (each visit comes with prescriptions, labs, messages, orders, recheck appointments, referrals, so on and so on. I have never left working feeling as if I completed my job, because it will never even be near caught up. We are just always doing damage control, triage and mop up)

So we have to limit how many new patients we see each day, in order to save as many slots as possible for the established patients. Other clinics can say "no new patients, our practice is full". Not community health care. Federal and state dollars come with the stipulation that nobody is turned away. Nobody is turned away, but we have to slowly add new patients.

I know personally that things were squeezed a bit to get this patient in, this woman with the broken wrist. Most likely it would have been another week, if the "rules" were followed. To clarify, any children we get in immediately if they are sick or injured. They don't have to wait, we will squeeze them in that day if needed. OB patients (pregnant women) are in the same category. Just to start prenatal care they may need to wait a few weeks, but if they are hurting or bleeding we will put them in no matter what. (even if the Dr's all have their 28 slots full, which is why we end up with 30 or more patients most days)

How is it that in a country with as many resources as ours, people would have to wait weeks to get an arm casted? How is it that with so much money involved in the health care system, we have a wide chasm many fall into? Why is it that the burden of meeting the immense needs of the many are left in the hands of a few?

So as I was washing this woman's arm, which had been under a splint and bandages for two weeks, she kept washing her face, her other arm, with the soapy water. She said it was so dusty outside. I asked where she had been showering and she said she had used the one at the day shelter about once a week, but she felt awful. I had her stuff two packages of baby wipes in her pockets to take with her. I asked where she had been sleeping, and she said that after the friend she moved out here to live with kicked her out, she had been just doing her best to find out of the way places to go unnoticed at night. Some nights she was in the shelter, but she was afraid of the other people there.

I must add here that I see all sorts, the very mentally ill, the disabled, the addicted, and I really think she was not entirely hopeless. I can see that probably not long ago she was productive, functioning. I don't know her full story, nor did I ask. I just want to be the gentle smile and word of encouragement to those in front of me. That is why I am community health care. I have learned not to invest my heart, because then there is nothing left of me. this has not been the easiest lesson for me in this life.

She was clearly in a lot of pain. the process of washing and then casting her arm was not entirely gentle, and she shed some tears. She said that if she still had any of the vicodin she was given in the hospital she would have taken one ahead of time, but they were stolen. Her hospital record said that she was given 20 pain pills. It would have been entirely understandable if she had used them up in the two weeks she has been in pain, without a cast.

The Dr said not to worry about it, she would write her a prescription for more, say 20, but there would be no refills.

The patient asked her if she could make the prescription for less than that. In my healthcare experience, NOBODY asks for less pain pills. Even healthy people might think that the will use the few extras just in case, to have tucked away in case they re injure that knee or whatever.

This woman, in extreme pain, who has had to wait 2 weeks to get her wrist properly immobilized, said that she would have to panhandle in order to get enough money for a few pain pills. She asked for the Dr to only write it for 5.

Our system is broken. Seriously broken. This could be you, your mother, your sister, your old 2nd grade teacher. It could be the college student living on ramen or the new father, who gives up his own needs to meet the needs of his child.

The crisis out there, the one that most people don't see, it can't be fixed by just a few soldiers. We need an entire national effort to stop this.

I truly weep as I watch this finally being addressed by an administration. I don't care how many people tell me that individuals need to be responsible for their own health care. That it would be an un-democratic move to move in the direction of socialization. I invite any naysayers to just spend an afternoon sitting in the waiting room of a community health care center. Last I heard, it is likely that many of them will see themselves reflected in the faces of the estimated 40% who have no health insurance. That number is expected to rise in the next few years.

I wanted to pull a handful of bills out of my wallet, to help this woman manage her pain. but I can't fix it, I can't save them all alone. Are you willing to help? If so, send an email or letter to your representative, and tell them that health care reform is important to you. It is important to us all. Tell them that you believe every single American has the right to basic health care.

I was the first to sign her cast. I drew a great big red heart, with the words "Be Strong" boldly printed in black. I hope she is strong, and is ok in the end.

passages

I find myself at this odd juncture of life. Somehow the birthday I will wake up to tomorrow feels significant. It is not just the number, though I sort of choke it out when I say it. It could be watching my children grow into young adults, especially my oldest who will graduate from HS next year.

It just might be the gray hairs, the ones that surprise me first with their texture and then as I fish them out of my bangs, their color. so how does this change happen. Do they grow out gray, and I just didn't notice them until they were 6 inches long, or does the color slowly fade from youthful hairs until they reach this sneaky gray?

So I am aging. I am passing time, in fact when you take into consideration my chronic illness and such, I am likely in the second half of my life now. While that doesn't scare me, it does cause one to pause for a moment, in reverence of things to come.

I have watched my mother, who seemed to slip into this phase of life relatively slowly, just now showing the years of worry on her face. My mother in law has taught me much about embracing and celebrating what you are, where you are truly. Seeing her happily wrap herself into the crone we all become makes me look forward to being the wise sage, observing the family from that spot.

I am so in between. I am a mother, but it is a different sort of mother than Iused to be. No more diapers (oh how I miss those cute cloth diapers!), no more breastfeeding (anywhere my baby needed it, thank you very much. Oh, and until age 4 *oh* did I hear a gasp?) no more baby toys, no more cute little outfits that I get to choose for the day.

Now I enjoy the lack of cleaning butts with poop on them, I do miss nursing, it was such a part of me, of my relationship with my children,and a way to really appreciate by miraculous body.
The kids become so independent, and I know they need me now, but it is just such a different way. Where are the mom groups for me? So many online communities that I was a part of, but grew out of. I could find a playdate, er, no playdates for the 17 yr old huh?

I am just not expressing my disoriented feeling very well in my sleepiness.
I do not fear my 37th year. I am wiser, more exprienced, I have done much, many wonderful things. I know that the coming decade, the 40's are supposed to be the best of all for women. I look forward to it, truly. My kids need me less, and I am finding that it means I can need me more. I need to take advantage of that more. I see time in the coming decade when my husband and I will be alone, just us. We never had that as a newly married couple, because we provided my husband with an instant family. But I look forward to time alone with my husband. I look forward to more bike rides on Saturday afternoon with my true love. I have so much to look forward to.

But I feel like I need to start getting it right. Whatever it is. I need to begin to carry myself more gracefully. I need to think of the wisdom I have to share in the moment, instead of an hour later and that person is gone. I need to wrestle with the gray hair, Shall I color? Can I color yet let my gray sparkle? I love red, I just was lacking the gene to really give me red hair color. Can I go red and still let my grey show?

So many worries,, so many bridges to cross, or streams to wade in.

So as I write this,I am sitting in bed. My incredible husband sent me to bed, with my new birthday toy... hmmmmm. Naughty or nice you wonder?

Well I have on my lap a new laptop. but it is not just a laptop, it is the laptop of my dreams! Because of my chronic illness I spend a bit of my resting time online. I have another laptop that has served me just fine. I dont need fancy stuff, don't game, I just surf and gather info, chat with friends. But my other laptop is old, like maybe 5 years old. It works for my needs, but is heavy. When my pain is significant I have trouble carrying it. Or if I am really weary, bummer.

So I have in my hands a tiny minibook, those new super sweet laptops about the size of a large book. This opens up so much to me, truly. I can take it with me, it won't hurt me from the weight sitting on my lap. I won't have to lug it up and down the stairs... I am blessed. I so adore my husband for thinking of this, for blessing me with something so useful to me.

A small energy savings

Last weekend, our garage door stopped working. It is one of the older electric garage door openers and had been having little difficulties for a while, but this time it went kaput. The problem is that we park our bikes inside the garage (no, the car doesn't fit) and every morning it's opened twice, once when my daughter leaves for school and once when I leave for work. Likewise twice in the evenings. I tried fixing it for a while but I'm no garage door mechanic so I gave up, having better things to do. I installed a manual slide lock so it could be secured from the inside and it's good to go. A small inconvenience to open it manually. 

Then I thought about it. I realized this was an opportunity rather than an inconvenience. I can save energy costs! I was inspired some time ago by the Fort Collins net-zero electric energy home, and maybe this is one of many steps I could take to reduce my energy consumption at home.

I did the calculations (see comments for my actual calculations) and found that I will be saving $68.58 per year on energy costs by having a manual garage door opener in place of an electric one.

I was speaking with a coworker about this very calculation, and she pointed out that the marginal utility of having an electric garage door opener versus a manually-opened garage door is highly in favor of the electric opener, given the cost savings. For some people, spending $5.71 per month to have an electric garage door opener is worth the cost. For myself, it's not; we only park the bikes in there, not the car, and don't use the remotes -- just open it from the inside anyway. 

For now, I'm happy with the arrangement. The cost savings is definitely worth the marginal utility loss.