Affordable Healthcare for America Act

It's been a long time in the making. Some would say decades. Yesterday, the House of Representatives debuted their healthcare bill to the public. But is it good? Is it really for America? Does it really emphasive the care of our health? I haven't read all of it yet, but I've already seen many concerns raised by bloggers and heathcare advocates on both sides of the debate.

(If you're ready to tackle it, you can check it out here: http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687&catid=156&Itemid=55)

I've become exhausted in the months of this debate. I am especially stressed when I hear from dozens of people about their struggle through un- and under- insurance. And I myself am stressed. I am still wading through the pile of bills, trying to sort them out, making sure I'm not being over-charged for medical expenses incurred this year. I've become so overwhelmed that I recently accepted a family member's help in sorting through the mathematical enigma.

As of January 1st, out monthly insurance premium will increase from around $100 to $140 dollars. At the same time my husbands hours at work are being cut due to the company not meeding its financial goals. I have not had any luck in finding a job, so we are still limited to one income, and the generosity of family who help us to pay the bills. Also on January 1st, the great ledger of our healthcare deductible will once again clear to ZERO and we will face the responsibility of paying $3,000 for the first chunk of healthcare we receive, before the insurance starts to pay 80%. It's almost as if this year didn't count because as of the new year, we are right back where we started. With the exception of new knees, of course. My medications alone cost nearly $900 a month. That's more than our rent and utilities combined.

I want to be excited that Congress is moving forward with a "plan" but I don't believe that it's a plan for the people. I think the bill is riddled with exceptions to benefit the insurance and pharmaceutical companies, and very little assistance for the people who need it most. In short, I don't think we have a good solution. I didn't donate to Obama's campaign, but if I had, I would declare I WANT MY MONEY BACK. His campaign promised healthcare for ALL. He championed his plan over his main party opponent, but now at the most critical time, he is giving in the challenges of bipartisanship and letting down those who voted for him. I am disappointed in our elected officials and find it harder by the day to believe they really care about their constituents.

When I was interviewed by NBC 10 Philadelphia for the TV segment, the journalist asked me where I saw myself in one year. I was unable to answer her question because the idea of 12 months from now scares and discourages me. I looked over at my husband who was sitting on the couch, watching the interview, and his face looked as blank as I felt. I can barely figure out what we're going to do in the next couple of weeks, let alone in the next year.

FACES OF PRE-EXISTING CONDITIONS

I've started a new project. It was inspired by a friend on Facebook, and I want to share it with you. I also want to get as many people as possible involved!

Please share with your friends and anyone who may be interested in participating.

The site is: FACES OF PRE-EXISTING CONDITIONS

http://facesofpreexistingconditions.blogspot.com/

Thanks!

-Lisa

Q. What do you get when you cross a blogger with new knees?

A. An infrequently updated blog.

Okay, I will never win awards for my jokes, but that's my excuse - less time on the computer, less blogging.

I had a great follow-up appointment with my surgeon. I no longer have to take a blood thinner medication (and with it goes the bi-weekly blood tests!), and I also have the green light to drive again. Recent x-rays of my whole legs (hip to toes) show that my legs are PERFECTLY straight and aligned from the hip to the knee to the ankle. Not only is this the intended outcome from surgery, but it will also lead to the longest lifespan for the knee implants because they will "wear" evenly and properly. It was truly fantastic news to receive!

My job search continues and I'm still keeping my options wide-open to any possibilities that may come this way. There's a certain camaraderie that I'm trying to embrace, knowing I've gone from non-working to the millions of job seeking Americans.

The mail carrier brought the first hospital bills today...post to follow once I unearth the calculator.

NYTimes: Let Congress Go Without Insurance

From The New York Times:

OP-ED COLUMNIST: Let Congress Go Without Insurance

What better way to attune our leaders to the needs of their constituents without health insurance than to put them in the same position?

http://www.nytimes.com/2009/10/08/opinion/08kristof.html

For weeks I have wanted to say something witty or wise about the ongoing debate. The theme that keeps returning to me is that for every day Congress spends enmeshed in the tedious, beureacratic political process of working toward comprehensive reform, hundreds of Americans file for bankruptcy and lose their homes and savings over unaffordable medical costs. I've worked in politics and understand the process is never a fast one, but I can't think of a time in American history when the expediency of passing legislation was so closely tied to the dire consequences for people's day-to-day existence.

Little Rebel at the Gym

I FINALLY made it to the gym today. And may I just say, I rocked that place. I rocked that gym like I haven't rocked it in years. I have a rebellious streak and since my doctor told me to do as much as my pain allows, I've been speeding through this rehab process. Honestly, it's amazing. Regular physical therapy is so boring because I know I can do more.

I mentioned months ago that we have a membership at the YMCA for essentially nothing (thanks to community funding!!) and they just built a brand new facility 4 blocks from our apartment. Finding the motivation has been, admittedly, difficult. You know how there are things you want to do and once you DO them you're so glad you did? Some of you may even apply "going to the gym" to this concept.

Back to how I rocked the gym. I didn't have a plan exactly; I never really do at the gym. I just wanted to get a good workout without causing more pain. I used the bike for 15 minutes and then did at least 20 minutes of upper-body strength training. I followed that with 10 minutes on the elliptical, and 15 minutes of lower body machines. Many people think of the gym with disdain, as a chore that needs to be accomplished. But I really have fond memories of the great shape I was in a few years ago when I went regularly. One thing I have missed and dreamt about is the leg press machine. (See image above.) To me, the leg press makes me feel like a gym rockstar. There is something very "tough" about it. And today, I totally rocked 3 sets of 15 reps of 65 pounds! Yep, on my awesome new knees. And they didn't hurt for a second during or after. In fact, I couldn't feel anything in the joint at all! I've never used that machine without pain. I wanted to jump up and share my excitement with a fellow-stranger-gym-goer. If you've never known the setback of an injury or your body not working as well as it once did, and then regaining the use of it, you might not understand my enthusiasm over this seemingly simple concept. But doing those leg presses today was proof to myself that this surgery has taken me to a whole new level of getting back the things I used to love.

I won't always look forward to going to the gym, but I will enjoy this excited feeling of rediscovery as long as it wants to last!

Thank You to the Awesome Donors of Sept 30-Oct 3!

THANK YOU to the wonderful folks who have stepped up these past few days to donate to New Knees! Most of you are strangers. We've never met or spoken to one another. But you found me, you read about my journey, and for each of your personal reasons, decided to contribute. You've joined a group of well over 100 people who have helped to pay for the cost of my knee surgery. I think in this act, we are no longer strangers. And, as is the style of New Knees for Lisa, I want to thank you "personally" but with respect for your privacy...

KF, RW, MM, SD, KB, KW, PD, DD, MT, AC, KF, JB, JC, JW, WW, & TE!!!

Each day my life with new knees changes in wonderful, forward-moving ways. Today, I took a walk. For the sake of taking a walk. I didn't have anywhere that I needed to go. It wasn't a walk with a specific destination, chore, or task to be accomplished. I just took a walk because the weather was nice. For the first time in years, I can take a walk without pain. It may be the simplest activity. Most people start walking around their twelfth month of life, and many never need to pause to wonder how they do it. I hope that I never take for granted this simple act.

The money you have donated goes to pay the medical bills associated with my knee replacement surgery. To me however, New Knees has always been about more than that. Your donations have afforded me the chance to walk without pain. I need to say it again...

THANK YOU!

Before/During/After: Helpful Hints from a Girl with New Knees

I try to remember all of the things I promised to follow-up on. One of them is sharing the things I learned along this journey, specifically related to the medical treatment of getting total knee replacements. This is by no means an exhaustive list, but they're the most important points I am still thinking about at almost five weeks post-surgery.

BEFORE SURGERY
1. Do Your Research: If you know or think you need total knee replacement(s), start your homework early. Ask friends for recommendations (but take them with a grain of salt), do your research online, call clinics and hospitals that perform the surgery. Make a list of potential surgeons. Consult with your general practitioner, or rheumatologist if you have one. Remember, each person's experience is unique and ONLY ONE perspective. So take everything you hear in stride and be open to new information. If you have a PPO, choose a few surgeons that you want to visit to discuss surgery with. Make sure they are in your insurance network. If you are at the mercy of an HMO, talk with your doctor and negotiate with your insurance getting AT LEAST TWO consultations. Most insurance companies won't tell you this, but they have to let you get a second opinion when contemplating a major medical procedure. Make sure to get any pre-authorizations you need to avoid potential surprise bills. If you will be paying cash for your treatment, negotiate the rates ahead of time and get everything in writing. Doctor's offices and surgeons need to make a living, and while they want your business, many are willing to negotiate cost. Think about any special care you may need, and compare surgeons' approaches. For instance, I knew I wanted a doctor who had operated on young people with rheumatoid arthritis. Check out their credentials. Don't be afraid to ask questions! Ask how many TKRs they have performed, their success rate, and typical patient outcome. (If a doctor hesitates to answer your questions, gets defensive, or makes you feel silly/dumb/otherwise for asking questions, take caution. I think that good doctors will welcome your interest in being an informed patient.)

2. Prepare Your Life: Roll up the carpets, make and freeze meals ahead of time, set-up automatic bill-pay with your bank for credit cards and utility bills. Arrange for pet care. Think about home equipment you may need - a shower chair, commode, etc. Talk to your insurance about what they will cover. Make sure you have your medications filled in advance. Enlist the help of family, friends and neighbors. 99% of people are willing and eager to help. Don't refuse their offer! Think about what they may be able to do. At the very least, have a list of their phone numbers for help post-hospital.

3. Get Strong: I read a story about a total knee replacement candidate running three miles per day leading up to his surgery. Of course, my personal opinion is that if you can run three miles a day, you're NOT a candidate for surgery. This is a very rare circumstance. If you're like I was, walking a block, or biking on a stationary bicycle for even five minutes might be impossible for you. So instead, focus on your upper body! Get a pair of light freeweights and use them: bicep curls, arm presses, shoulder lifts, anything that gets your arms moving. I figured out a way to do modified pushups on my bed since I couldn't get down on the floor. Another suggestion is chair presses. All you need to do is sit in a sturdy chair that has stable arms, grasp the arms, and push yourself halfway up, then lower your body back down slowly. If you have neck or shoulder problems, this one may not be a good exercise for you. But if you can handle it, try to do a couple a day leading up to your surgery. Your upper body will be key post-surgery and I cannot stress how much getting my arms in shape helped me.

4. Once you have a surgeon picked out, and a date set, you need to have important pre-operative discussions. Make sure you know what the surgeon's plan is, and remember that YOU are in the driver's seat. Talk about the plan for anesthesia with the anesthesia team, ask how long you will be in the hospital and then decide if you will go to a rehab facility afterwards, or straight home and have in-home physical therapy. Also, talk about post-operative pain management. Understand your options and make your preferences clear to your physician. (Many factors will depend on your insurance. Don't be afraid to call them and ask for your plan on paper.)

5. Meet or at least talk to other hospital staff. Find the social work department and get to know them and their services on the phone. Find out how to reach the physical and occupational therapy departments, and the hospital chaplain if this is something you want. If you can, consider taking a tour of the hospital and/or rehab facility. Surgery has so many unknown factors; this could help alleviate some concerns on your mind.

DURING SURGERY
1. This one is both before and during. Pick a designated person or persons to accompany you to the hospital and if possible, someone to stay with you at least for the first night or two. Even if you pick out the best, most reputable hospital in the world, it is still helpful to have an advocate. You may be on a lot of pain medication and not feel like advocating for yourself. Give your designated companion a list of your daily medications, and make sure they understand your surgery and pain management plan. They can be especially helpful in watching that the nursing/hospital staff gets you what you need. Remember: Even if you have insurance, you are a paying CUSTOMER. Demand good customer service from the hospital. If anything happens, you should have that social worker's phone number handy. Don't be afraid to call them in to advocate on your behalf. You deserve good medical care. Mistakes are made, but I believe that being prepared can minimize many potential problems.

2. Follow your doctor's (and medical team's) orders. You've entrusted them with your care. While in the hospital, make sure you are eating a balanced diet. (If the hospital food is terrible, have your companion get you food from outside.) If the physical therapist gives you exercises or stretches to do in bed, do them. If you need to use a CPM machine, do it. Moving as soon after surgery as possible speeds healing and leads to greater strength and range of motion. Now, I am going to give you conflicting advice. If you think that something ordered is causing you undue pain, hardship, or you are feeling sick: SPEAK UP for yourself. Don't suffer unecessarily. Doctors and nurses are NOT mind readers. They need you to say if something doesn't seem right.

3. Be Germ Free: Wash your hands. When you are IN bed, use antibacterial wipes to clean your hands. Have your visitors wash their hands EVERY single time they enter the room. Have your medical staff wash their hands or use antibacterial lotion every single time, ESPECIALLY if they inspect your incision or examine you. If someone doesn't follow this protocol, report them to their supervisor. Hospitals are really struggling to keep infections and MRSA outbreaks under control. Insist that everyone who comes near you takes precautions to help you avoid catching anything, or worse, getting an infection at your incision site.

AFTER SURGERY
Let's assume you are leaving the hospital or rehab facility to go home.

1. DO YOUR EXERCISES. I will say it again. DO YOUR EXERCISES. I know, they suck. They're not fun, and they hurt. But the sooner you get strong, the sooner you will be able to get around, and when you can get around you will start to gain the life that you wanted to achieve by having the surgery. Get out of bed and walk around your house or apartment. If you can, have someone accompany you outside to sit in the sunshine. It's good for your body and your brain.

2. Eat Well. Hopefully, you have frozen food that is easy to prepare, or someone that can help prepare meals for you. If you don't, I hope you have some money to order healthful meals that can be delivered. Remember to get protein, and plenty of fruits and vegetables. Your body needs energy to heal.

3. Take your medicine. Continue to take all of your medicine on a daily basis. Don't skip it. If you've been put on anticoagulants, never skip a dose. I totally understand hating to take pills. But you've been prescribed them because they are important. I'm not a doctor or medical practitioner, but I am going to share my own thoughts on pain control. If you've been given pain pills, take them if you need them. But I also encourage you to try other more natural methods. Make sure to ice your knees multiple times a day. If you can do relaxation techniques or meditation that helps you cope with the pain, then all the power to you. At some point, you will have to come off your pain medication and the less you are dependent on it, the easier it will be. Now, for a contradictory recommendation: Since physical therapy is so important, take your pain medication before your PT sessions, and after if needed. It will help you work harder and therefore, get more out of your PT.

4. Remain positive. I KNOW that the first few weeks are especially hard. But try to remember why you had the surgery. You were likely in excrutiating pain, and had given up activities that you enjoy. In the first few weeks, the post-surgical pain might make it hard to remember why you had the surgery, and you may even start to regret it. Don't be afraid to talk to family and friends, who can gently remind you why you did it. I promise: it does get better and it does get easier. The pain will slowly decrease and you will get your life back.

Finally...

Total knee replacement surgery does not have a 100% success rate. But it is one of the most successful surgeries performed. If you dedicate yourself and imagine a positive outcome, you will likely accomplish getting your life back.

I wish you the best of luck, increased strength, improved health and many adventures on your New Knees!!!

Welcome to New Knees for Lisa!!

Thank you to NBC10 Philadelphia for sharing my story on air and online. You can follow the link here: http://www.nbcphiladelphia.com/news/health/New_Knees_for_Lisa_Philadelphia.html

(It will air again tomorrow at 5:30 in the Philadelphia region.)

If you are new to the site, I want to welcome you! You can read more about My Story here. I encourage you to read through the blog to the many links, personal stories, and views that have been shared. I hope you enjoy your time here and join the discussion.

I am loving my new knees! Tonight, we went to a local town fair. It was complete with great carnival food, games, rides for the kids, and plenty of people watching! Walking around I couldn't help but reflect on how many things I've done in my life that have literally "hurt" to do. We walked for two hours tonight and I had almost no pain! It was so enjoyable to take in the sights and sounds without constantly wondering how much longer my legs will "last" until I have to give up and go home.

This is only possible thanks to the generosity of the many donors and those who share the site with friends and family.

Thank you from the bottom of my heart!

Productive Member of Society?

My deepest musings happen late at night, often when I can't sleep. The past few days my brain has been occupied with questions about what will happen next in life. Admittedly, just about everything I ponder revolves around finances and when I will be able to find a source of income.

In the past year of unemployment, I've often said my goal in acquiring new knees was so that I could return to being a productive member of society. I need to confess that what I really mean is I want a paycheck. I just want to be able to pay my own bills. (If I can serve the community along the way of paying my bills, then that would be an added bonus.)

I'm casting a wide net in employment opportunities and sending my resume out to many people. I'm not being picky - and hoping this will serve me in attaining my goal of employment. I'm willing to work in just about any field (if my arthritis allows) for half the wages I made in the past. I'm even be willing to work for an organization or company and be reimbursed in health benefits only, if they are in a weak economic position and can't afford to pay me a salary.

Having a chronic illness has taught me the harsh but valuable lesson that you don't always get what you want (or think you want) in life. But this has also taught me that sometimes you need to work harder, smarter, and more creatively to achieve your goals.

New Knees Recipient Seeking Employment!!

I've shifted my online time from blog-focused to the greatly anticipated ambitious job search. I couldn't have picked a worse time to try to re-enter the workforce. Therefore, I am dedicated to being open-minded, pursuing opportunities in many fields, and being creative in my approach.

As you know, my main goal in getting knee replacements was so I can get back to working and continue my career.

Regardless of what some people say, I do not think it's a good idea to disclose health problems during an application process because an potential employer can easily pass you over, without ever having the admit why. Employers are, after all, picking from hundreds of candidates for a single position. Explaining my year-long absence from the workforce, without disclosing the specifics, will be one of my greatest challenges. (Though, if the employer is Google-savvy, they will likely find this blog and discover my reason for unemployment on their own!)

I didn't expect to start job searching this soon, but I am anticipating it may take months to find even a basic position. Given my new location in this smaller city, there are limited opportunities in my field, but I'm accepting that as just part of deciding to leave San Francisco.

Meanwhile, I am also developing a plan that I've dreamed about for a long time - staring my own business of editing and writing. I'm working with someone to develop a website, and seeking resources from the local SCORE office on how to find a target market and start the venture with essentially zero money. I'm realistic, however, and I know that this could take months or longer to get off the ground and earn me real income.

It's moderately consoling that I'm now one of millions of qualified, hard-working Americans who are unemployed. But that doesn't help our financial situation. It also doesn't help that as of January 1st, my healthcare deductible will be once again $7,600. Like many Americans I am going to see all of my specialists in the final months of the year.

It's a daily, harsh reminder of our need for healthcare reform. I do have increased hope by recent developments in Congress. The Republicans in the House of Representatives are slowly becoming less opposed to a public option, and our leaders are expressing a dedication to getting reform by Thanksgiving.

For now, I am going to search diligently and try to build my network in an area still relatively new to me.

I have a very diverse history of employment. Some of the things I've worked on and would be happy to do at a job include: public policy and healthcare policy; business policy; grassroots coalition building; partnerships with Congressional offices; event planning; membership outreach and marketing; recruitment for a University fellowship program; nonprofit networking; counseling persons with mental illness and history of homelessness; writing and editing for websites, political campaigns, and publications; extensive computer work including data entry; teaching English as a Second Language; administrative work including tasks as an executive assistant; international trade programs and training workshops; assisting on research projects and assembling a team of experts in tobacco policy. I recognize this is a huge list for someone only 5 years out of college. I've loved the challenge of every position. That being said, I am also open to opportunities in just about any field not yet mentioned.

If any of you know about opportunities for employment in the Lancaster area, or nearby...

If you know of legitimate online employment...

If you need editing, writing, or project assistance...

If your company/organization is looking for a passionate, creative, bright individual to join your team...

I would be happy to send you a copy of my resume!

Tuesday Humor

Protect Insurance Companies PSA from Will Ferrell

Looking for Guest Bloggers!

Have you been looking for an outlet to tell your healthcare story? Perhaps you have your own blog (or don't) and want to share with New Knees' audience an experience you've had in trying to attain health insurance.

This is an open call for guest bloggers. Whether you've donated or not, spoken with me, or not, are new or old to the blog - it doesn't matter - I welcome you to contact me!! We want to hear more personal stories.

You don't need to be a professional writer! (And you don't need to have a chronic illness.)

Let's build the voices on this blog. Contact me at lisa.ambrocio@gmail.com with your story. I'd love to talk with you!

I look forward to hearing from YOU soon!

-Lisa

Quote of the Day

"You can't complain about health care reform if you're not willing to reform your own health" -Bill Maher


What have you done to improve your health lately?

Do you spend more time THINKING about improving your health or actually DOING things to improve your health?

Do you rely too much on pharmaceutical drugs while ignoring your lifestyle decisions including your diet? Exercise? Alcohol? Smoking? Drugs? Stress reduction?

Could you save money and add years to your life if you made better decisions for your health?

Start today.

Filming in Philly

My husband and I had a fun Friday in Philadelphia. We left early to head to my parents' house to meet the journalist and camera crew around noon. Before surgery I got my hair cut short so it wouldn't be a nuisance in the hospital, and while it looks good some days, it isn't a real style, nor do I know how to make it look good. So of course, this was what I was most worried about leading up to the interview.

The station's team showed up and set up their equipment. From the minute the journalist came into the house, we launched into a conversation and there was a near seamless transition from our greetings until we sat down and she started asking me questions. She wanted to go over everything chronologically - essentially, what happened to get me to the place where I decided to start this blog. We talked about rheumatoid arthritis and how it affected me in high school and college. We discussed my decision to go into health policy and my passion for politics. She asked me about why and how New Knees for Lisa got started and what its meant to me over the past few months. I got the chance to talk about the notes you've sent me and how humbled I've been by the donations from strangers and friends, alike.

We talked about my decision to have surgery and how that came only after exhausting other less-invasive measures, and out of a desperate desire to go back to work and do normal things. (I must have mentioned grocery shopping a few times, because she pointed it out and said something like "You must REALLY like grocery shopping." It's sad, but true.)

Then, we got into our discussion about healthcare reform. She gave me the opportunity to talk about what I believe we need in a reform plan, and if I really believe we can accomplish it. I hope part of this makes the final cut in production.

The camera guy asked my husband and I to walk together so they could film B roll. One word: awkward. As soon as I'm expected to do something "natural" or "normal" I clench up and am utterly clueless. They suggested we talk to each other, but I laughed because I had no idea what we would talk about. They took some more footage, and in under an hour and a half, it was finished and they were packed and on their way.

No date set yet for airing, but I think it will be in the next week or two. GOOD NEWS: The clip will definitely be available on their website.

While in the city we got to visit my Grandfather and one of my brothers. I have to (and by that I mean, I've been told I HAVE to) use my walker when I am out of the house. It makes sense for safety since I don't have perfect balance yet, but sometimes when I get out of the car I start to walk away without it, until my husband calls after me. There were months when getting out of the car was such a slow ordeal. What are the words to describe what its like when you no longer need a walking aide on a daily basis?

After visiting we headed back home and I crashed unto bed, thoroughly satisfied with the interview, being able to see family, and enjoy the beautiful almost-fall weather.

Thank you for this...

It confounds my brain. It's overwhelming and humbling and amazing. I can walk without my walker. Better than I have in two years, or three, or more. So long that I can't remember exactly. With less pain than since my 14th birthday. With my legs straighter and easier to move smoothly. They don't give out on me, nor do they have to be manually straightened. I can walk normally and put my heel down before my toes. One foot in front of the other, instead of the pound-pound-pound flat-footed stomping that I've been getting by on for months. I no longer sway back and forth or limp. I can stand up straight in front of the mirror. I think I might even be an inch taller now.

It's mid-September and this was just about the time I received my diagnosis of my very swollen, stiff knees in 1997 when I was a freshman in high school. How could I have ever known what the next decade would look like? Or that at 26 I'd be overwhelmed with the generosity of dozens of friends and strangers who helped me to afford new knees?

How can I thank the nearly one hundred donors who made this surgery a financial reality for me? Saying Thank You isn't enough.