Why healthcare sucks

This is not a political blog entry. This is an entry of a personal story, which illustrates the craziness and absolute lunacy of our healthcare system in an event that happened to me this week.

As a state employee of Wyoming, I get up to $500 for “Wellness Visits,” which are supposed to be preventative care. No deductible, no fee. Free. Up to $500. Not only that, but a wellness exam is mandatory for you to get a discount of $480 of your health insurance premiums throughout the year – a good deal, to say the least.

On July 12, I went in for my annual physical exam – my wellness visit. It encountered all the regular annual physical stuff – blood pressure, pulse oxygen screening, weight, height, the female stuff – you get the gist. And, I should point out – this is usually my only visit to the doctor during the year.

Three weeks later, I got a bill from my doctor for $50 that my insurance didn’t cover. Well, it’s supposed to be covered, up to $500, like I said, and the original bill was $196. So I called the insurance company.

Me: “Why did I get billed for a wellness visit when it’s supposed to be covered up to $500?”

Helpful and perky insurance agent: “Because of the way the doctor coded your visit, it was billed as a visit with other services. You need to get your doctor to change the way they billed it. If they bill it as a wellness visit, we’ll cover it.”

Cool.

So then I call my doctor’s office.

Me: “Yes, hello – I got a bill for my wellness visit, and I was told that you need to re-bill the insurance company so they’ll cover the entire exam.”

Also nice lady: “Let me see here – let me look up your visit.”

Waiting …

Lady: “Oh, well it says here that you talked to the doctor about migraines, so that’s not a wellness visit.”

Me: “First of all, I’ve had a history of migraines for the past four years. She simply asked me how the medication I’m on is going, and refilled my prescription. Isn’t that part of a routine annual exam?”

Lady: “Well, if you discuss any symptoms, that’s not technically a wellness exam.”

So let me get this straight. In a program that is supposed to have a preventative focus, if you talk about anything that might require further care, it’s not covered. So if you happen to be having regular stomach pains lately, they’d rather you say nothing and then later have to treat your cancer rather than getting it early and taking out a tumor.

The doctor’s office lady told me that she knows it’s stupid, but now she has to get a provider to review my file and make the determination of whether it can be re-billed as a wellness visit or not.

Regardless of the outcome, I already have my game plan for my next mandatory wellness visit, about a year from now. When the doctor asks how I am and if I’m having any problems, I’ll just look at her and respond:

“I’m well.”

I came, I saw, I ... conquered?

Well, perhaps "conquered" is a bit strong. Regarding the two races I’ve been training for, worrying about and obsessing over for the entire year, I finished both, thus meeting my goals.

It may not sound like much of a goal: to finish something. But anyone who has ever taken on a marathon or another endurance event can sympathize. The Laramie Enduro was a 70.5-mile mountain bike ride (that’s with the small detour my race partner and I took after missing one of the turnoff signs) that took me 10 hours and six minutes to complete. It was challenging, fun, and one of the most gorgeous rides I’ve ever done. It was definitely the most well supported ride I’ve ever done. Volunteers, food, course – it was a fantastically well planned and supported from start to finish. Kudos to the Enduro folks.

A quick rundown: at the starting line at 6:45 a.m., riders riddled with goose bumps in the cold morning air, an announcement comes over the sound: “Make sure you walk the bridges, always follow the course … and, oh yeah, at around mile 7 you WILL be attacked. I repeat … you WILL be attacked.” A Goshawk (whatever the hell that is – a mean bird, apparently) had recently taken up residence near one of the trails and was protecting her nest with her life — and her huge talons. Luckily, the expert riders started before us. They must have tired the poor bird out before we got there, for all we heard were angry squawks as we rode by. Incidentally, this is also the time a man passed me who was pedaling a bike without a seat. I don’t know if it fell off or if he was planning on doing the whole race standing. Weird.

After we got past the hawk, we traveled through some scenic gravel roads and into the familiar singletrack trails of Happy Jack. With 30 miles beneath our tires, we followed the course across the Happy Jack highway for the next section – only to find that after a few miles down a gravel road, we were conspicuously alone. Coming to an unmarked fork, we determined we had gone the wrong way, and backtracked to find the trail, which promptly when down a hill, into a marshy area filled with cow shit. I guess you’re not racing until you’re covered head to toe in cow manure.

At the next checkpoint, around mile 40, my beloved Cheetos were waiting for me in our drop bag, along with a 5-hour energy I took with me just in case. But I was feeling surprisingly spry and ready to go. Unfortunately, Jim, my partner, was feeling fatigued. We rested a few minutes so he could pop his cramp-preventing pills and I could eat my Cheetos, my personal antidote to cramps, hunger and a foul mood.

Coming out of the third aid station, we went through some sagebrush-covered singletrack as we spun through fields littered with cattle, who couldn’t have cared less about us. Then we popped out onto some more forest service gravel roads that appeared to have one purpose: to take us to heaven. They were all uphill, and they all climbed so steeply that when you looked up, all you saw was the looming hill above you and blue, blue sky.

Not to toot my own horn, but on this section, I was a champ. I felt good, my Cheetos and energy bars were treating me right, and I was climbing like a friggin machine, hammering hill after hill in my granny gear. Unfortunately, the climbs were not as good to Jim. Feeling the first twinges of cramps, he continued to bravely soldier on up hill after hill. During one portion, I summited a long, sustained climb ahead of him, only to see at the top that another long, sustained climb awaited. “Jim, don’t look up,” I shouted back. “Just keep pedaling – you don’t want to see what’s ahead.”

Luckily, after being passed by a few support guys on motorcycles who wanted to make sure we wouldn’t end up as buzzard meat, we crossed the highway and reached aid station 4. Of all the aid stations, this was the most festive. They had music, people cheering loudly, and it was fun. Jim sat down to pop more pills, I went after some watermelon and Gatorade. When I got back to him though, he had a soft taco in his hand, which was apparently the last one. He offered it to me, I refused – but I’ll bet that was the best damn taco on Earth.

Once we left, we faced more climbs up to singletrack that circles a mountain. Up down, up down. At mile 55, I was pausing at the top of every climb for Jim to pedal up, in agony against his seizing legs, which were beginning to cramp badly. He urged me to leave him, I told him I didn’t want to. He said he didn’t think he could make the cutoff. In that moment, my entire seven months of training flashed before my eyes. If you don’t make a cutoff, they give you a Did Not Finish, put you in a truck, and drive you back to the start. I got mad just at the idea. This would not happen to me. So I left.

The next few miles were more brutal up down, up down. But near the end of the singletrack, there was a field filled with wildflowers as tall as my waist. It was like a freakin’ Allegra commercial – so beautiful words don’t do it justice. But it was the last beautiful moment of the race for me. I got back on the gravel roads that would take me back to the last section of singletrack before the finish, and then got onto Headquarters Trail, a brutal 1-mile section of climbing switch-backed singletrack with technical rock gardens scattered throughout. I rode what I could, I walked the rest. At the summit, a group of teenagers cheered me on, bored that they had probably been out there for hundreds of racers before me, seeing that I looked more pathetic than any of the others that had passed through. Didn’t matter, I just kept spinning.

By this time, my neck had flared up and I had numbness and tingling all the way down my left arm and a sharp stinging every time I tucked my neck to my chest. This is the real limiting factor for me in riding, and it was making me acutely aware of my mortality at that point. Yet I kept spinning, slowly and deliriously until a pudgy guy (and I say that affectionately, as one with pudge of her own), whom I had dusted earlier, passed me. “What am I doing?” I asked myself. “Get your ass in gear and finish the fucking race, Kat!” So I did.

The next weekend’s ride, the Copper Triangle, was not nearly as grueling. It was about 80 miles of road, which had three serious climbs in it, the last of which is Vail Pass – not something to take lightly. But other than starting out at 38 degrees and not being able to feel my fingers until an hour into riding, the ride delivered as promised: great, friendly people (it was, after all, a fundraising ride, not a race), wonderful support stations, and breathtaking vistas of Colorado’s mountains. It took us about seven hours, and I wouldn’t want a minute more on my road bike, which makes my neck feel like I want to pull my head off and just set it on my handlebars.

Oddly enough, Vail Pass was one of my strongest climbs throughout the day, but that’s not unusual for me – it seems my legs don’t seem to warm up until around mile 50. But the thing to know about Vail Pass in the Copper Triangle is there is motivation in the form of big, chewy, chocolaty brownies that are waiting for you at the top. I can’t think of a better reason to climb a 10,000-foot mountain.

I owe a lot of thanks to people for their support as I undertook my two challenges this summer. First and foremost, thanks to my husband. I had to sacrifice my weekends to be out on my bike, which means he had to sacrificed his weekends because we couldn’t go anywhere. He also gave me words of encouragement during my ups and downs of training, mostly by saying “You’ll be fine … you always are.”

Also, to my race partner, Jim, who came out from Missouri to do these crazy events in elevation with me and put up with my general crankiness and know-it-allness during our three-day trip to Yellowstone and the Grand Tetons in between races, thanks. Without your arm warmers on the Copper Triangle, I would have frozen, and without my gas stove in Yelllowstone, we would have starved. J

Also, to all the people who were forced to look at my bruised and battered body all summer, I thank you for asking how it’s going and taking a sincere interest in my undertaking. A special thank you to my friends, all the football ladies and my coworkers, you were incredibly supportive about all this. As some of the people I spend the most time around, it meant a lot.

So my predictions from my last blog entry were mostly correct, although I’m happy to report there was no blood, I got over my cold in time, and although I did swear never to do another one, I’m already looking at what’s on the horizon for next summer. With any challenge I’ve done, I always seem to find that no matter what, you can always endure more suffering, more pain, and more miles than you think you can. But you never know until you try.

Race Predictions - Two days to the Enduro

It started with that heavy-head feeling. Then a few errant coughs and sneezes. Soon after, the throat was sore, and my body was tired. It’s official … I’m sick.

Of course. Two days before the 72.5-mile ride I have trained five months for, I get sick. I suppose I could blame the recent bout of cooler weather, or my husband who brought the vile virus into the house to begin with, but I won’t. People get sick. That’s life. Correction – that’s my life two days before a race.

Nevertheless, I thought it would be fun to make some race predictions, at the risk of what superstitious people might see as jinxing myself. So here it goes.

I predict I will finish both the Laramie Enduro Mountain Bike Race and the Copper Triangle road race, which takes place next weekend, Aug. 7. I predict it will take everything I have and more to finish the Enduro. I predict I will feel like crying, quitting and dying, but I will do only the former of the three. There may be tears – there will probably be blood.

After doing a solid 50 miles of singletrack last Friday, I took two epic crashes, both of which dotted my body with a nice painting of black and blue marks and red scrapes. I predict I will probably add to those on Saturday, although I predict I will not actually hurt myself badly enough to stop. I predict I will wish I had given myself an excuse to stop, but, finding none – I will continue until I die or finish. I predict despite my massage yesterday and daily treatments and stretches, that my neck will hurt so bad I’ll want to yank my head off.

I predict it will be fairly cool with some decent cloud cover. I’m an optimist, so I predict it will not rain. I predict I will have to walk the last climbing section of the headquarters trail (fellow Enduroans know what this means).

I predict (and pray to any God who will listen) that I will finish in less than 10 hours, and at the finish line I will want to drink lots of beer, but I will be too exhausted to do so. I predict my race partner, Jim, will lift my spirits and I will lift his. I predict we’ll have several good stories to tell by the end of the day.

I predict I will tell myself I am never doing this race or any other of its kind again. I predict this will be a lie.

So there it is. The day after the race the plan is to go up to Yellowstone and Jackson to detox from the saddle for the few days, then come back to town and repeat on a road bike the following Saturday. I predict I will worry less and take that race easier than the Enduro.

Hopefully I will come back a winner for having finished both races. I can’t even consider having one of them being the first race I don’t finish in my cycling life. Positive thoughts.

One final prediction: I predict these next two weekends will be fun in only the sick way races that take all day to complete can be. Wish me luck … I might need it!

Too bad, so sad

Have you ever found yourself reading a really good book that happens to be really sad? More importantly, did you ever notice that a huge proportion of books ARE really sad?

This is the realization I came to a few weeks ago when a friend came over to La Casa de Hughes (actually, more like La Duplex de Hughes) for dinner. She works as an LPN at a nursing home, and had a depressed patient she was worried about. She thought it would help cheer her if she could spend of her ample free time reading some good books.

“No problem,” I told her, knowing that my husband has fought to keep every single book he’s ever owned, including his textbook on Medieval Russian Literature from his junior year of college. Let me tell you how thrilled I have been to lug heavy boxes across the country in countless moves for books he will never so much as open again. Yet I digress.

What this means is we have one of those huge, industrial shelves that normally hold pots in a restaurant holding books in our office.

So, taking my friend up the stairs, I was sure I’d find something for her patient to read. After all, I had read almost everything on those packed shelves, and there are many wonderful books in there I really love.

“We just need to make sure that they’re not sad,” my friend said. “I tried looking through my books at home, but I couldn't find any that weren't sad!”

I started diving through the spines on the shelf, reading out some of my favorites.

“A Farewell to Arms – sad. The Color of Purple – kind of depressing. Book of Lost Things – gloomy. Marley and Me – God no!”

Textbooks notwithstanding, it seemed almost all of my books were either weird (I love John Irving, the freak) or super sad.

I’m not sure why I didn’t realize this before. I even made the mistake of taking Cormac McCarthy’s The Road to read during our Costa Rican honeymoon last year, only to end up buried for hours in the hammock on our private patio overlooking a magical rainforest, hiccupping sobs of tears with each page I turned. And this is my idea of a good time.

So I settled on Seabiscuit and Memoirs of a Geisha – not entirely uplifting, but at least not bawl-your-eyes-out reads.

The experience got me thinking about good books, and why they’re sad – why they almost have to have some sort of sadness to make them interesting. Perhaps it’s the genre I’m into – I don’t dig the scifi or mystery or romance stuff, so I guess the kinds of books I enjoy must rely on drama to build climax because they can’t rely on other tools of storytelling, such as mystery or a lot of suspense. I love following awesome characters in their stories, and to identify with awesome characters' trials and tribulations, there might be some tears involved.

Below I’ve created a list of books I love and think are great reads, but I’d love to hear about your favorites. Give me your suggestions – and what do you love about the books you love? I can’t wait to hear. I’m always looking to add more to my list, and don’t worry — I’ve got plenty of Kleenex.

Kat’s list of five favorite summer reads (nothing too heavy):

1.) Three Cups of Tea

I’m in the middle of this book right now, but I’m in love. This is such an uplifting and inspiring story of a man’s journey to build schools in war-torn Pakistan. It puts our lives as spoiled Americans in perspective.

2.) Travels with Charley

What a great summer read. The story of John Steinbeck, touring America in his camper with his poodle, Charley. My favorite part? His observation that the interstate system has homogenized the American experience. And this was in 1960.

3.) A Prayer for Owen Meany

This is my favorite book of all time. I love it for the way John Irving pulls you into his weird tales of perfectly ordinary people.

4.) The Secret Life of Bees

A tale of triumph and the female sprit, as well as a lesson in entomology, all wrapped into one heartwarming and empowering story.

5.) Water for Elephants

An enchanting tale of the circus life and the depression, which leads to a lot of action and a fantastic finish.

Bike to Work Challenge: DAY 50!

Riding to work today felt just a little different.

The wind blowing in from the west was the same, as was the flow of traffic and my path to work.

But there seemed to be something a little different - maybe it was the smugness I was feeling at achieving the first quarter of my goal.

In March, I issued a challenge to myself to Bike to Work 200 days this year. I think this is quite a feat considering I live in a place with some of the shitiest weather you'll ever see - but that was kind of the point. If I could do it here, people in other places really have no excuse.

In the past three and a half months since I began, I have slipped and fallen three times on ice, ridden in 50 mph winds more than three times, and witnessed some of the most amazing vistas right down the hill from my house. One morning, when I was pedaling with my head down, I almost ran into an antelope buck who was crossing the street, trying to get out of my way. I think it freaked me out as much as him.

50 days of riding means I have biked to work an equivalent of 300 miles so far. It's not an earth-shattering number, considering I ride 100 in a weekend with my training, but it has saved nearly a full tank of gasoline for my car.

Of course, my feeling of smugness eroded somewhat when I realized that 50 days in 3.5 months puts me exactly a half month behind my goal, and if this is when it's warm, how many days am I going to get when it starts getting cold?

I didn't know if 200 days was a realistic goal when I set it, but once I started looking at the calendar and realized that vacations, retreats and travel for work would eat up my possible slack, I decided I would allow myself to make it up with bonus trips. These are trips I would normally take with my car (like visits the store, to run short errands, etc.), but I count them as a day if I do them on my bike and they are a comparable distance.

In short, I have lots more work to do - work that will get much more interesting once the snow starts again in September. But until then, I'm enjoying the sun on my face and the beautiful ride that is Laramie in the summer.

The Delinquent Blogger — Me

There are some people in this world who are on top of things. They go to the dentist every six months. They get their movies back to Blockbuster on time. They get their oil changed every 3,000 miles like clockwork. In short, they are in tune with the demands of life and they excel at meeting them.

I am not one of these people.

I am from the other kind of people. I lose my keys frequently. My cell phone goes dead on a regular basis from me forgetting to charge it. My house goes through cycles of clean and unclean, tidiness and disarray. My family members always get to celebrate their birthday with the arrival of my card about two months after their birthday. Sometimes I feel guilty about it, but mostly I think others should lower their expectations for me. It’s worked for my brother for years. If I had to characterize “untogetherness,” I would defend it by saying I’m not wholly neglectful; I’m merely a person who operates on cycles.

So it is not surprising to me to pull up my blog, only to see that my last post was March 24, when I began my personal bike-to-work challenge. You may be disappointed in my ability to keep everyone updated, but I want to tell you that you can at least feel satisfied knowing I will update eventually — I just like to build the suspense. For about four months. Once again, low expectations.

However, now that my summer classes and vacations are done until my mountain bike race July 31, I have my blog on my to-do list. So, although I’d like to pretend that I’m jealous of the first kind of people — the together, oil-changing, birthday-cards-on-time folks — I realize I’m somewhat flighty, preoccupied and unreliable in this sense. And you know what? I’m OK with that.

So stay tuned … I’m in a cycle of busting out some blog entries this summer. Finally!

The Bike-to-Work Challenge

The thing about living in Wyoming is there's always an excuse NOT to do something. It's too far ... it's too cold ... it's too windy ... blah blah blah.

In the past, I rode my bike to work in Florida (13 miles each way) and Missouri (1.5 miles each way - with a monstrous hill and a creek in the middle), but I have found LOTS of excuses not to ride the 3 miles from my house to work in my year's worth of living in Wyoming, where it starts snowing in September and doesn't stop until June.

Thinking about what a whining little sissie I've become in a place where people are supposed to be "cowboy tough," I decided it was time to make some goals.

Goal 1: Get off thy (increasingly) big butt and register for some bicycling races this summer.

Accomplished. With the help of my riding buddy in Missouri, we have signed up to do the Laramie Enduro, a 70+ mountain bike race on the trails of my mountainous backyard on July 31, and the very next week the Copper Triangle, a 78-mile road ride that crosses Fremont, Tennessee and Vail passes in Colorado. I was planning on jumping without looking when a friend said, "Vail pass - whoa. When's the last time you drove over that?" Shut up. I don't want to think about it.

Goal 2: Put together a plan to train for said races and stick to it.

Thanks to Amazon.com, I got some great books to help out with Goal 2, and I think I've been about 70 percent compliant with the plan I've set up, so I feel confident that I'll be ready for these races in a little more than four month's time.

Goal 3: Bike to work at least 200 days this year, beginning March 15.

Let me start by saying that this a completely arbitrary number. I thought it would be challenging. I have no idea of how attainable this goal is, and I didn't really think about it that hard. Now looking at it, I'm kind of scared, but 200 is a nice, round, ambitious figure that will sound super cool if I can say "last year I biked to work 200 days." Not that I would :-)

From a geeky perspective, if I accomplish Goal 3, that means I will save 6 miles a day from my car's odometer, which is 1,200 miles a year. Given that my car averages about 35 miles per gallon in town in cold weather, that means I will save 35 gallons of gasoline. At a price of about $2.50 per gallon, this will save me about $88 in a year. So as you can see, I'm not doing it for the money. I'm sure there will be times when I will be willing to pay $88 for a ride. But it will save me nearly four trips to the gas station, and considering I only fill up once a month now, that will cut my annual gas bill by about one-third, which I think is impressive.

At this point, I'm happy to report that I have six days of commuting under my belt, and already I have biked through two blizzards and crashed on the ice once. So even if I fail miserably, and drive to work more than 55 days this year, at the very least I will have earned some interesting stories to share. Stay tuned ...