Tag: life

An American Health Care System Reflection: Costs

As the government shutdown in the United States continues, I wanted to take a few minutes and share a bit more about my healthcare journey this year. I am sitting on more privilege that other American peers. For all my health problems since March of last year, I haven’t born an unreasonable amount of health costs. I have my primary insurance and secondary insurance through the Department of Veterans Affairs. It’s the access to the second insurance that has made a difference in being able to seek medical care to the extent I’ve needed in my quest to understand the underlying condition causing my joint pain, nerve pain, lack of physical endurance–all of it.

Before digging into some financials, I want to say, I still have no answers on the cause but the evidence is continuing to point to an auto immune disorder. Earlier this month, I had some additional testing to rule out monoclonal gammopathy of undetermined significance (MGUS) that can develop into multiple myeloma. The bloodwork came back with no evidence of monoclonoal gammopathy and the hematologist also ran an Erythropoietin test for me since there is a blood disorder/cancer called polycythemia vera that has a lot of similarities to the symptoms I’m experiencing. (She had no concerns with the results that came back.) The abnormalities that we are seeing on repeated tests are elevated immunoglobulin M (IgM) levels, which can be evidence of a recent infection (which I haven’t noticed) and autoimmune disorders. The difficult thing for me is other than one positive ANA (Antinuclear Antibody) test, all the other tests that look for autoimmune conditions are negative including the ones that look for specific markers of lupus. This last time she ran an Anti-Nuclear Ab, IgG ELISA test instead of the ANA due to it being more sensitive and the results came back ‘none detected.’

After this last round of testing, I did inform the hematologist, I want to test out a theory of mine. I want to treat my next round of bloodwork in a similar fashion to a cardio stress test. I’ve been reducing my physical activity and have had less exposure to cold environments, which help manage my symptoms and I think that’s part of why my tests are inconclusive. I think if my second-to-last primary hadn’t been such a barrier to seeing a rheumatologist earlier, I would have had bloodwork that shows a true reflection of the inflammation when I hadn’t yet figured out how to manage my symptoms. To try and trigger a response is not something I’d recommend someone else pursue; I don’t know what damage this might do to my body, but I feel it’s one of my last options available to me to get the tests to show what body processes are malfunctioning when I try to live a more able-bodied average person existence (cooking more, doing more chores, exercising maybe an hour a handful of days in the week).

I hadn’t thought about how much of my health challenges I would share earlier this year and then I realized for someone with similar problems, it helps to hear from a kindred spirit running a gauntlet of tests for answers. From very basic research, it’s not uncommon for someone with autoimmune issues to go months or years until a diagnosis is made. (I’m hoping we’re not at the years plural part for me, but I’m already past the one year mark now.) So let’s shift to talk about how expensive all these things are.

Again, not expensive for me due to my particular situation, but this could be an absolute nightmare for someone else. When you sit and look at the battle of the government shutdown, affordable access to healthcare is not a small matter. And I will also say the pending lack of SNAP benefits for many of my fellow Americans IS ALSO not a small matter. And federal workers going without pay IS ALSO not a small matter. I know far too many individuals impacted by the government shutdown currently and it’s hard not be able to assist everyone without also putting my own fiscal security at risk.

Rather than let the conversation run away from us, let’s focus on the charges for some of these medical visits and tests.

Sometime before mid June, my health care costs already hit my family deductible ($3,300). Due to my decision last year to make use of my VA healthcare benefits in tandem with my outside medical coverage, I haven’t had an out-of-pocket expense. I was hesitant to switch care providers, but I went to a non-VA emergency room years ago and paid $200 out-of-pocket to be seen and saw what they charged my insurance company. I knew if my health worsened (and it has!) I’d get to the point where my medical care costs would be unsustainable and I’d potentially have to avoid seeking medical care. Letting medical problems fester is not the solution.

So I hit the deductible before June 15, 2025. ($3,300).

In August 2025, a visit to a neurologist resulted in a $401.08 charge.

A visit for bloodwork in late August had two separate billings: $660.05 and $456.36.

Bloodwork in September (a total of 13 line items) was billed for $2,477.00.

A Veterans Affairs Community Care neurology visit (meaning I saw a provider outside the VA) in September where I was only seen for 6 minutes–six freaking minutes–resulted in a bill for $307.55.

I needed that visit to request a skin punch biopsy, one of the tests to help diagnose a potential “lupus cousin” autoimmune disorder.

My October bloodwork (11 individual line items) ran up the largest amount billed in the amount of $2,937.00.

The physician services portion of that same visit ran in at $359.00.

Dear readers, that comes out to $10,898.04 of medical expenses and no answers.

I cannot receive any form of targeted treatment until we’ve determined what’s broken.

I am blessed that I don’t have to find a way to pay this, but many of my fellow Americans have that problem. That have zero answers and nothing but bills for their time. They are drained physically, mentally, emotionally, and financially. Their plight for affordable health care is different from someone who rarely, if ever, needs medical care and who looks down on those with frequent doctors visits. Your neighbors aren’t a drain on the system; most are trying to lead better, healthier lives and if their health isn’t improving, they’re trying to have a comfortable existence until they pass away. Have some compassion. Anyone can have their lives turned upside by a medical problem.

A recent photo of me. You wouldn’t be able to tell how crazy my health has been this past year.
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A New Beginning

Just over a month has past since I left my position with the Department of Veterans Affairs, and I’m liking my newfound settings. I was a presenter today for my new organization, not adding a whole lot to the overall day’s activity with the one PowerPoint presentation, but I was honestly surprised just how many questions were generated off my suggestions.

I carried a lot of doubt with me into my new position. It’s hard not to–I served veterans for the bulk of the past twelve years. As each new day gives away to another, I am starting to see it has all been quite relevant. I’ve gotten so used to laws changing every year that I look for the little tweaks that have the biggest impact. Today, I discussed with the lawyer present in the room how I didn’t have the interest or stamina to put myself into the legal field but my public work is adjacent to it and I feel I found my calling. A calling more natural to me than serving veterans. When I cared for my previous population, I often struggled to separate myself out for the situations they were in; I guess pretty normally that one veteran would want to keep another veteran from struggle. In my new role, I don’t have names and faces that I serve; I look at them as a giant group who need my respect, diligence, and patience to build a better system of tools to access benefits, understand their performance tools, and so forth.

Like my work with the VA, I will remain closed lipped on my current employer. Should we later terminate this working relationship, I will likely discuss my work with greater reflection on lessons learned, salary, and so forth.

Today’s blog entry was really a lot of sharing that I am happy and in the best paying position of my career. I’ve never earned six figures, and it’s wild, scary, and empowering. I get to see all my hard, unpaid (excluding VA education benefits) efforts in school and struggling through periods of underemployment helping me build a better legacy for my family.

Stepping out of veteran-centric spaces, I don’t know where the future of this blog will go. Maybe a name change will be in order. Maybe a new focus will reveal itself. For the time being, I will continue my quest to write monthly and be a voice of strength and encourage others to pursue their wildest (legal) dreams.

Before I close out for the day, a health update is in order.

My newest rheumatologist thinks my health problems are a lupus cousin, Sjögren’s, although I haven’t noticed the most common symptoms. She is also looking at the possibility of small fiber neuropathy. We still have work ahead of us, so right now, I am just accepting the summer heat is my best source of managing pain and choosing to not donate blood whenever blood donation opportunities come up since I don’t know if it’s safe for me or any potential individuals needing a blood donation.

Take care and I’ll try to drop in again in August.

Sincerely,

Cheryl

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Saying Goodbye to My Federal Employment “Dream Job”

Last month I forgot to check in with you all—my sincerest apologies might not mean much as I’m a stranger to most of you all, but I try to keep my “appointments” with you. A friend date of sorts is how I’ve tried to start treating my writing check-ins.

For those who have also kept up with checking in, you’ve seen me struggle with how the Trump Administration has treated federal employees. The stress since he returned to office runs the spectrum: some people barely notice him and others have had their jobs ripped away from them. Adding to the situation is the complicated feelings within families regarding values. My heart truly goes out to my fellow federal employees who lost their positions only to face the insult of family members cheering on this slash and burn approach to reducing the federal government. Many within the federal government would also tell you there are more efficient ways to do things, but cutting jobs before assessing what they actually contribute to public safety and services puts the public at risk that negates whatever reduction in spending resulted from it.

I was also stunned that the message was “reduce federal government spending” while rolling out the Deferred Resignation Program. These two short-term objectives are directly in opposition to each other and then the mixed messaging associated with DRP added other challenges as agencies sorted out what roles qualified—a kind of reverse sorting hat than the one in the Harry Potter films and books. Instead of asking ourselves what traits suit someone to a particular house (or job), the agencies have had to ask themselves in whittling down their forces per the Reduction in Force guidelines thrust at them what jobs are more valuable to the mission and what has the appearance of redundancy. I won’t say what jobs are redundant, because as our society has grown it was wholly necessary to increase the federal workforce to provide more services and more timely services.

I had a great local team in my current role who have helped enable me to keep my position while navigating my current health challenges. My supervisors never stood in my way of the medical appointments I needed and I had the open door policy to ask any myriad of questions to be better at my job. With choosing to leave, I feel it’s safe to open up about the type of work and why I’m leaving.

For just over two years, I’ve made the Department of Veterans Affairs my home and just last year I became a Rating Veterans Service Representative (RVSR). I would review claims for disability compensation, and I loved a lot of what I was tasked with to serve our nation’s veterans. This is the job I started chasing down years ago. I thought critically about what I’m leaving behind: a supportive coach and assistant coach, coworkers and friends I care about, and a meaningful mission.

So what happened?!

The return to office order added challenges to my quality of life. Although I am continuing a workup for lupus, I have the mental energy to keep working. What I needed was a reasonable accommodation to telework under my old arrangement because the cold of the office environment and extra physical activity increase the severity and frequency of body pain I’m dealing with currently. We occupy GSA-leased buildings and are prohibited from using space heaters at work. We also have limited parking, so the employee parking lot was limited to more senior employees based on service computation date. I found an alternate parking arrangement, but it does mean more physical activity that worsens my symptoms.

I started the reasonable accommodation process back in late February and when it was still lingering close to the return to office date, I even asked for an interim RA at the start of May. The request was still lingering when I inquired about it last week.

I am fortunate my coach and assistant coach were willing to hear me out on my frustrations and understand why I am leaving. The hope is my complaint and departure lights a fire for positive change.

I am working through the background check for a new hybrid position that has employee parking on site that should allow me to better manage my symptoms, allowing me to retain employment on par with my education and career background. For now though, I am working on getting my home and wardrobe in order for the new position and trying to relax a little amid this originally unplanned career departure.

—Cheryl

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Closing Out Year 39

Good afternoon, everyone.

I am on the cusp of turning 40.

Most people outside my family don’t know that I was born premature and medical staff told my mother that I wasn’t going to make it. This woman who already had a one year old child at home. A young mother, she was not content to believe these individuals whose educational experience I still cannot compete with in spite of holding two graduate degrees. She was stubborn. She refused to believe them and relied on the love and prayers of many to see me through. Medical technology for preemies wasn’t as great in the 80’s as it is today, so what was at their disposal and the people who loved me and so many I’ll never meet who prayed for me got me through those difficult early days.

And when I say difficult, I’m talking three months premature. Oh yeah, and this was a twin pregnancy for my mother. I came into this world a tiny little thing. 2 pounds, 4 ounces.

How my mom could look at me in such fragile state and believe all would be ok in this world floors me. My husband and I greeted our own daughter years ago with the news she would be born with a limb difference and I remember being so anxious during that pregnancy and scared of all the things this world might rob her of being due to her limb difference. But I wasn’t scared she wouldn’t survive. She was a healthy 6 pounds, 6 ounces. My mom could have been one of those mothers planning a funeral for her baby.

And around the world, so many mothers have been doing just that years and years over. On top of the wars in Ukraine and Gaza, this January mothers of three soldiers lost their babies in Jordan when their base was attacked and earlier this month, moms of five Marines lost their kids when these young men died in their helicopter crash in California. Their deaths are something that struck right at my heart, having handled the activity reports for 1st Marine Division during my first Iraq tour. Their lost lives continue to encourage me to appreciate everyone who fought to keep me alive as a baby, something I cared little about when I was at rock bottom coming home from that first tour.

This situation is in part why I went to the Department of Veterans Affairs for health care for the first time recently. (The other part being that private health insurance is getting out of hand and I feel that my primary doctor might not be best suited to connecting all my health problems to service experiences.) I’ve struggled for the past year with edema. For my regular readers, I know, another health issue. My body is in a weird IDGAF stage. They just keep coming. I went to the ER last April after I gained 9 pounds in two days from fluid retention. From the 5 hours I was there, a series of tests didn’t reveal much except for an abnormally high B-Type Natriuretic Peptide in my blood work. Since this issue can indicate I am at more risk for heart failure, I appreciate that my local VA team is taking the matter seriously.

I’ve been trying to take care of the edema on my own, without going back to my non-VA primary medical provider this past year. That ER visit alone was pretty pricey and I was fortunate most of it was covered by insurance. It wouldn’t be financially feasible to have my regular insurance cover what the VA is doing to investigate the source of my edema. My vitals were taken and we did an EKG during the same visit, without delay. Both individuals asked me about my symptoms and the challenges the edema is creating in my life. I did not want to admit to anyone earlier that I can barely work out currently. I used to work out around an hour to two hours a day either lifting weights and/or jogging around my neighborhood. Now, I struggle if I walk too much in a day. Running is out of the question right now. If I walk too quickly, even a mile long walk brings on edema that lasts most of the day. I even alternate sitting and standing to bring some relief. I’ve switched to 20-30 minute at-home yoga sessions and plan to continue with these videos, even if I find one day coming up I can add running and weights back to my routine. Our daughter joins me as I work through Yoga With Adriene videos. Her companionship makes me feel a little less sad that I cannot workout as hard as I was prior to developing edema. The situation though is not a standalone matter.

When I visited the other day, we covered some of the introductory things, not just the edema. I felt it was imperative to discuss with the medical provider my concern that years of PTSD physical pain, in the form of chest pains, might be weakening my heart and therefore be the connection to the abnormal peptide level. (If we discover the edema has another cause, that’s just as valuable. I just need to know what’s happening so we can treat it and life feels more normal.) We’re waiting on blood work to rule out other issues and in the next few months, I have a cardio stress test and an ultrasound of my heart scheduled to see where my heart function is standing today. The professionalism of the involved staff members is something I want to reiterate today because the VA has not always had the best reputation and I was nervous to use VA health care after it took years for my chest pains to be recognized by the Veterans Benefits Administration as service-connected. I don’t really like talking–writing is easier–to strangers about my service experiences right away, but the visit entailed a brief mental health check-in.

I had a few triggering situations a short duration ahead of my scheduled medical visit, but I would encourage other veterans to be honest about their mental health struggles. For me, there was a scene in “Band of Brothers” (The Breaking Point episode) where Joe Toye is hit by artillery and loses his leg. I was watching it with my family last weekend and it hit me so hard. We bypassed the rest of the scene. The situation brought on a panic attack and the day wasn’t helped either as we tried to unwind with a walk and I wasn’t paying attention that a neighbor was setting up model rockets for some kids. Keeping this experience in mind, I was compelled to let the provider know that I’d recently had an uptick in symptoms and that I am easily startled. We’ll tackle a mental health visit another day, but I want to focus on two other things in this conversation because suicide prevention and personal safety matter to me. I want other veterans to feel like it’s ok to talk to their providers about similar (or worse) things they’ve experienced to ensure they receive appropriate care.

It was a lot to admit to the VA that I contemplated suicide in 2005 after serving in Iraq and that during the tour, my supervisor touched base with me about a male Marine who had made threats against my person. I recognize to avoid feeling suicidal in the future, there are certain ways I control my environment to feel safe. Sometimes, it has an impact of friends and family around me, but often times, it’s more an inconvenience rather than projecting my pain upon them. A big thing that helps is controlling my alcohol intake. I am happy to admit that it’s been years since I’ve drank a kamikaze. That was the drink I’d indulge in to numb my pain. Abusing alcohol is something that I could have sought treatment for in the Marine Corps if I felt it was safe and wouldn’t fuck with my career, but as the only woman in my unit, it was something I didn’t take seriously. I am lucky it didn’t progress further, but I would encourage others to put their health and wellbeing above the mission. The service will ALWAYS find enough people to fill its billets, even if it requires moving people into temporary additional duty assignments. I am fortunate I didn’t die by my own hands. The only commitment I made to myself was making it through the worst night of my life, and I actually talked to my sister, Megan, about this when I went home in January for one of my uncle’s funerals. I made the choice to stick through my pain for her back in 2005. We had a terrible relationship growing up and I didn’t want that to be a memory for her. She was my lifeline well before I admitted it to her. It’s not something I want to talk about today–that pain still hurts–but I love the space she’s given us to be closer as adults. The second issue–military sexual trauma adjacent or directly, depending on who you speak to–is not something I’ve ever talked to a doctor about. I’ve never understood how to approach it. I was unsure how to take speaking to my supervisor, my mentor and a pseudo father figure on deployment, about someone who abused my trust. When I discovered he made threats against me, I wasn’t sure what that meant for my safety when I would eventually return stateside. (I don’t have the full details, so I decided to say fuck it and put in a FOIA request to see if the Marine Corps would have a record I could access. The likelihood of ever working with or encountering said person again is highly unlikely, but I might as well arm myself with knowledge just in case.)

I had enough going on in my life with my grandmother’s declining health to fully address how to cope with the situation that another Marine might pose a threat to my health and wellbeing. And, now years later, it probably had a huge impact on my friendships and the addictive relationship I had with my partner at the time. I accepted a lot of red flag behaviors that were offset by the fact I knew we were both war fighters. He could physically protect me as I could protect me. It wasn’t until I returned home when I had to turn my rifle into the armory and my flak and helmet to CIF (Consolidate Issue Facility) that I was more vulnerable in a physical and an emotional way.

I never once asked my command why the problematic person was gone when I returned. People leave units all the time and I didn’t put two and two together, but I notice how the risk to me put me on guard with others in my life. Did it play a role in my alcohol abuse? I don’t know that I could distinguish that situation separately from other events in Iraq. It does make me concerned about the people our daughter might one day encounter and/or date. As a nation, I think we’ve accepted poor behavior on the part of men as the norm and we still have a long way to ensure that men don’t resort to violence, threats (of any kind), and disparaging women to make themselves look better in comparison to other men. I’ve communicated to my husband what boundaries I’ve developed from this situation. It hasn’t stopped me from maintaining a longterm relationship, but it took a long time to see that what I went through does, in fact, fall under the umbrella of military sexual trauma. When I previously discussed my military experiences with a professor at Arizona State University, I wasn’t originally willing to believe it fell under that designation because it wasn’t sexual assault or what we recognize sexual harassment to look like.

I don’t want to end today on a sad note. It’s exciting to be turning 40 tomorrow.

I took today and tomorrow off, resulting in a fantastic 4-day weekend chock full of fun adventures and lots of relaxing. I will treat myself to a Good Humor Strawberry Shortcake ice cream bar inspired birthday cake with a side of Tillamook strawberry ice cream. My birthday cocktail will be a strawberry tequila sour. We have dinner plans Saturday and another event, centered on our daughter, for Sunday. My actual birthday gift is an experience I’ll get to enjoy in April. I will probably share more about it after the event. And I wanted to give an update on our 2024 financial goals.

  • Get promoted at work. (Feb. 29th: Still working on getting promoted.)
  • Sell 2nd house. (Feb. 29th: We’re still considering this, but it is contingent on what the promotion looks like and where the promotion opportunities are located.)
  • Order new passports. (Feb. 29th: Ordered and in processing. We spent $160 each for the adult passport and passport cards. Our daughter will be 14 this year, so her passport renewal and passport card costs us $115.)
  • Travel: 1 big trip. (We have zero idea where we want to go. Haha.)
  • Travel: 3 staycations (Feb. 29th: We have one staycation planned; the other two are still TBD.)

Enjoy all the days you’re given. Life is short. Have fun and show up for yourself.

~Cheryl

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