SOL18: Assisting a Local Journalist: Future Story About Coping with Obstacles to Success Faced by Locals

I received a Facebook message from our star local newspaper’s photojournalist that she was in the process of co-authoring an article about obstacles to success faced by locals: poverty, medical/mental disabilities, incarceration, and lack of housing. I was flattered that she wanted my input; she’s been a favorite acquaintance and neighbor for a few years. You’ll notice that I added “coping” to this article.

I’m a former teacher who is disabled with COPD and asthma. To get on SSDI, I went for tests at a local hospital–East Texas Medical Center. Later I got on Medicare and became connected with the East Texas Council for independent Living (ETCIL) and entered a nursing home for eight months. I got two overdue surgeries while I was there. However, I couldn’t get discharged until I got on Medicaid and was turned down the first time. So I went to the Records Department of ETMC and got a complete list of my Emergency Room visits for the previous four years. Most of y’all have probably heard that Texas is the largest state not to have Medicaid expansion. It’s so wonderful to have Cigna health care. I get maintenance medicine, have a pulmonologist and a G.P. that are really great and nice, and discovered what else was wrong with me health-wise. I study my Asthma-COPD Overlap Syndrome and have a binder and a couple of folders on the illness; some articles are by me on my Word Press.

I mentioned that I went to the City of Tyler Neighborhood Services to get an apartment rental discount through the Department of Housing and Urban Development (HUD). The local center for independent living relocation specialist facilitated the process. Later when I moved across town, I did it all myself. Before I got on Meals on Wheels and SNAP Food Stamps, I went to a couple of local food pantries once per month.

Besides specifically telling her to call Neighborhood Services and ETCIL, I told her about my main volunteer activity: East Texas Human Needs Network (ETHNN). We have five committees: Education, Employment, Healthcare, Housing, & Transportation. Transportation is my main focus because I ride the bus regularly, as I quit driving several years ago. I’ve arranged field trips with lunch for all five lines. We went to both shopping centers, two grocery stores, and Neighborhood Services. I also attend Education and Healthcare committee meetings.If more people rode the bus, we’d have less traffic, pollution, and more bus routes.

Just between us for now, I’ve really been trying to advertise the importance of finding a match between personality and college major choice/vocation. The local university wants to improve its graduation rate, so I sent my article on the topic to a couple of friends who work there. Furthermore, career counseling centers should advertise the free online Myers-Briggs Type Indicator (MBTI) instruments.

To conclude for now, I told the photojournalist that I may not make much money, but I don’t spend much either. Just because one may be a retired teacher (prematurely, in my case), a teacher never quits teaching.

Questions to Ask Someone with COPD (2nd Edition), by J.D. Meyer

1. What inhalers do you use? A rescue inhaler, like Pro-Air, was my first. Now, I usually take Combivent.

2. Do you use a nebulizer with albuterol or albuterol-ipratropium? Nebulizer fluid is an extra strength version of rescue inhalers with the same chemicals.

3. Do you use a twice daily inhaled corticosteroid, such as Advair or Symbicort?

4. Do you have a pulmonologist? I go to Pulmonary Specialists of Tyler on Fleishel, behind ETMC. Dr. Luis Destarac is my doctor. I get allergy shots there too. I’m allergic to Bermuda & Johnson grass.

5. Do you have lots of phlegm sometimes? Take Mucinex, and you can get the generic version at Family Dollar that’s cheaper.

6. Have you ever been to the ER for an exacerbation? Have you been there lately? More often or less often over the years?

7. Do you have sleep apnea? Do you have a C-PAP?

8. Do you have an oxygen machine with nasal canula?

9. Do you still smoke cigarettes? I quit a few years ago.

10. Have you ever had asthma? Child asthma can go away, & it’s more common. I developed asthma at age 28 & COPD at age 46. Asthma-COPD Overlap Syndrome (ACOS) is characterized by more dyspnea (breathlessness), more phlegm, but better response to inhaled corticosteroids (such as Advair). Some COPD inhalers, like Onoro, can be fatal to those with asthma also!!

http://www.healthcommunities.com/copd/early-stage-copd.shtml Early COPD.

https://bohemiotx.wordpress.com/2017/02/05/dealing-with-a-bad-copd-exacerbation-maybe-dodging-an-e-r-visit/ On reducing ER Trips.

Budget ACA: 3-10 Essential Benefits, 2nd Edition, by J.D. Meyer

1. Ambulatory patient services. [Outpatient care]
2. Emergency services.
3. Hospitalization. [Inpatient care]
4. Maternity and newborn care
5.Mental health and substance use disorder services, including behavioral health treatment.
6. Prescription drugs.
7. Rehabilitative and habilitative services and devices.
8. Laboratory services
9. Preventive and wellness services and chronic disease management;
10. Pediatric services, including oral and vision care.

Health insurance plans must cover these benefits https://en.wikipedia.org/wiki/Essential_health_benefits

Right now, it’s all ten or none. Pay a fine if you choose none……. How about a budget version: (2) Emergency Services, (6) Prescription Drugs, & (1) Ambulatory patient services [Outpatient care]? Limit eligible clients to those who make $20K/year or less.

Let’s change the paradigm from younger healthy people would rather pay a fine than go for all ten. My new proposed paradigm is let the poor choose the three most important!

I know what it’s like to work over 40 hours/week with three part-time jobs and no insurance: adjunct instructor at a community college, construction assistant, and substitute teacher. This was my career from 1994-1999. I’d developed asthma in 1987. Trust me, summer is construction asst. only, and that faded out of the picture after I got a full-time teaching job (2001-2006), followed by COPD (2005).

Why did I choose those three benefits? Emergency Room visits are very expensive, and in the USA, we let the sickly get help and hopefully pay later. I got on Medicaid by showing my record of ER visits from 2008-2012 to social workers, despite living in Texas—the largest state not to expand Medicaid.

I could afford an inhaler and nebulizer fluid, but not Advair. Fortunately, I learned about botanicas from living in a predominantly Mexican-American neighborhood and got gordolobo (mullein leaves) and eucalyptus.

I went to clinics that generally served the poorer part of the population. Through “Ambulatory patient care [Outpatient care],” more would be able to afford the office visits themselves and have a regular doctor.

I hope my “Budget ACA: 3-10” brings a helpful new angle to American Health Care. It’s such a hotly debated topic, and we seem to have more difficulties than most OECD nations. My first edition was mistaken in choosing 9. Preventive and Wellness Services and Chronic Disease Management over 1. Ambulatory Patient Services [Outpatient care]. Outpatient care is more basic.I bet plenty of poor people would rather buy “Budget ACA: 3-10” than pay a fine–looking forward to feedback.

COPD Dude Goes to a Chiropractor with the Impulse Adjusting Instrument, by J.D. Meyer

I taught for 20 years, especially Developmental English/Writing & ESOL–before my COPD got too bad. Now I’m on SSDI with Medicare, Medicaid, and Cigna Health Spring insurance. I have gone to chiropractors on a regular basis twice in my life–after my asthma diagnosis and need for an albuterol nebulizer, but before the COPD verdict: emphysema and bronchitis.

Bratcher Chiropractic is a father-son team and the only Cigna-approved chiropractors in Tyler, Texas. The chiropractic science has really changed in the last fourteen years! There’s no more roller ball on a table kneading your back like bread dough, followed by the doc popping you with his hands in the three regions of your back. Nowadays, there’s a wild little machine that looks like a home construction tool called the Impulse Adjustment Instrument, and it is wonderful! The pamphlet describes the benefits as (1) Extreme Speed, (2) Controlled Force, and (3) Frequency Tuned Waveform.

The Extreme Speed refers to the Impulse being “twice as fast as other adjusting instruments, and 100x faster than manual adjustments. The gentle thrust is faster than the body’s tendency to tighten up and resist the adjustment.” Believe me, my neck used to be very resistant to popping by hand! Controlled Force describes the “three different force settings for different parts of the body and to treat patients of all ages.” Frequency Tuned Waveform shows that the “Impulse is specifically tuned to the natural frequency of the body that joints, muscles, and nerves respond.” The impulse is “controlled by micro-computer circuitry housed within the device.”The Impulse Adjusting Instrument is patented and an FDA (Food & Drug Administration) registered device.

So far (three visits), my doctor has commented that I only have 50% movement in my neck and a dislocated rib cage! It turns out that the bad lung crowd is vulnerable to such rib cage issues. The sessions are really faster than chiropractic treatments of yesteryear.

By the way, I quit driving a car several years ago, and have become a recognized authority on the the Tyler Transit. It’s a journey starting with Purple South (or Red South), followed by Yellow SW. This time on the way back, I just took one bus to the second hub–Bergfeld Center and walked the 1.3 miles home.

When I got home, I happily made the following announcement, “I just overcame a mental block. For the first time, I walked home from Bergfeld Center (actually the CVS to be exact). I walked down Broadway to beautiful Charnwood, then crossed over to Houston from tiny Niblack. I had just been to Bratcher Chiropractic. My FEV (Forced Exhale Volume–peak flow meter) was a staggeringly high (for me) 350 upon entering my place!!….Many times I’ve walked home from La Michoacana and Downtown–roughly the same distance. …Ready for the I have a Dream event Downtown at 6:30.”

I will be going to Bratcher Chiropractic twice a week for several weeks. While I wait for the Yellow SW to return, I’ve gone to a Wal-Mart grocery store in search of strong cheap red wine and beer, granola bars, and spicy Taki snacks. My backpack contains reading and writing material, along with my lined canvas bag for groceries–and even lunch. So my adventure is more than medical, it’s travel to an unfamiliar part of the city for me.

I’m keeping my G.P. and pulmonologist updated on my progress–a practice that reveals my love of teaching and research. Remember those middle back vertebrae are connected to your lungs. Consider getting chiropractic treatment if you have asthma or COPD.

Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (4th Edition)

By J.D. (“Joffre”) Meyer
Those of us with COPD (Chronic Obstructive Pulmonary Disorder) live with the strong risk of an exacerbation that is severe enough to go to the Emergency Room by way of ambulance. I developed asthma 18 years before COPD too. We face a mix of lung spasms, excess chest phlegm, and a low FEV (Forced Exhale Volume). Asthma-COPD Overlap Syndrome (ACOS) is known for increased breathlessness and sputum–but a better response to inhaled corticosteroids.

It’s typical for me to have some coughing and wheezing when I awake, and sometimes after a walk. Choice #1 is using an asthma rescue inhaler, such as Combivent or Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. Combivent is stronger, and it also has ipratropium. But the likelihood of its effectiveness goes downhill if our attack is more than simply mild. Rule #2 is not to take the long-term inhalers during an acute attack, such as Advair or Symbicort, and Singulair.

So we go for our dear friend, the nebulizer, and pour a vial of albuterol or albuterol-ipratropium in the receptacle. We get “Albut-Iprat” when our condition becomes worse. I just started getting Combivent, the stronger “Albut-Iprat” inhaler. Our next choice is mask or “pipe.” Most say the pipe-like hose is better because we get more of the medicine. So here’s my first original suggestion. If you wear the mask, put your oxygen canula up your nose (assuming you own one). Really tired COPD sufferers may have difficulties with the pipe. Lately, I’ve switched back to the pipe-like breathing tube. Furthermore, I’ve started holding a lozenge in my mouth while I inhale my albuterol from the nebulizer. The lozenge is menthol and maybe eucalyptus too. That way, the cooling anti-inflammatory elements of the lozenge shoot directly to your lungs, as opposed to staying in your mouth and keeping you from coughing phlegm. My guess has been approved by real doctors!

Speaking of phlegm, keep a plastic can with a lid handy, such as my old Folger’s coffee can, the regular 10.3 oz. size. Don’t even consider swallowing that phlegm. I’m not trying to be funny because it’s not. Don’t expect to be able to run to spit in the nearest toilet or sink either. Make sure you drink enough water too–a likely weak area for most people. 1.5 liters daily should be enough since other fluids are okay; vegetables and fruits are full of water too. I use an attractive purple jug for my water, so I’ll notice it better! I can keep the squirt cap on when I take my many morning pills. Then I remove the cap for water guzzling! Now I’m exploring fruit-flavored water to increase my likelihood of really hydrating. Furthermore, local water systems have been breaking down lately!

Now let’s look at the OTC (over-the-counter) medicines. For your chest congestion, take some guaifenesin; that is, Mucinex or a generic version. COPD is a mix of emphysema and bronchitis. Bronchitis is like having a perpetual chest cold while emphysema is a destruction of the lung sacs and a lack of elasticity in the lungs.

What if you have nasal congestion? A saline nasal spray will open a constricted nose. Later I submitted this article to COPD Breathing Buddies of Facebook, and I was warned about Sudafed. This drug may reduce nasal congestion, but Sudafed can raise your blood pressure, which may happen anyway during a COPD attack. In the past, I added Mullein leaves (gordolobo), eucalyptus leaves to my morning coffee drip bin before I got health insurance but lived next door to a Mexican botanica. My goal is to reduce inflammation. Garlic pieces and ginger slices work too.

If you have severe or moderate COPD, take your Daliresp pill. I have allergies to Bermuda & Johnson Grass, so I have allergy pills to take–an OTC generic equivalent of Claritin called Loratadine, a non-drowsy tablet and now Montelukast, my newest prescription. Montelukast is actually the pill version of Singulair, and one of the cheaper lung-related prescriptions. I keep a daily pill reminder box by my bed, as I have a total of six per day–not all bad lungs related. By the way, since you’re taking all these pills have a water bottle next to your bed. The more water you drink, the more the mucus will be thinned.
Here’s my second original tip. If you have a C-PAP machine for sleep apnea, you can use it when you’re wide awake to force air into your inelastic, sagging emphysema-ridden lungs! Don’t overuse your nebulizer; try a wide range of strategies to stop the COPD attack.
Lately, I started taking Vitamin D and magnesium. I read a wonderful booklet about the benefits of magnesium for the lungs after my move of February 2018.

Please check out my methods for battling severe COPD exacerbations! Maybe I have a higher tolerance for pain than many, or a fear of walking home from the E.R. before sunrise? I wrote this article after coping with a severe attack lasted for 1 hour & 40 minutes; editing followed the intial blog!!
And when you quit choking, take those long-lasting spray/powders: Advair or Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. After this epic COPD attack, I got a shot of Salumedrol, a steroid, at her office. Then I got prescriptions for prednisone pills and a Z-Pac antibiotic.

“Asthma-COPD Overlap Syndrome (ACOS),” Footnotes & a Commentary from a Patient (6th Edition), by J.D. Meyer

 

“Asthma-COPD Overlap Syndrome (ACOS): A diagnostic challenge,” was a Top 100 WebxMD article for 2015. http://onlinelibrary.wiley.com/doi/10.1111/resp.12653/full It caught my attention because I’ve had this condition for ten years; however, I never heard the two described as a unit in this manner! Three symptoms stood out on my first reading: increased sputum, more dyspnea (breathlessness), but better response to inhaled corticosteroids. At once, I told all my local health connections about ACOS. This article was written by three doctors in the Far East: Vietnam, Korea, and Japan. “Tho, N. V., Park, H. Y. and Nakano, Y. (2015), Asthma–COPD overlap syndrome (ACOS): A diagnostic challenge. Respirology. doi: 10.1111/resp.12653.”

Furthermore, a Google search for ACOS yielded nothing unless I entered the complete term. So the breakthroughs didn’t happen around here—adding to this disabled Developmental English/Writing—ESOL teacher’s sense of urgency!

Definition of Terms

I printed this article and started highlighting and making notes. Fortunately for me, many of these technical terms corresponded to familiar brand names for my many ACOS drugs. Symbicort is a Long-Acting Beta2-Agonist (LABA) and an Inhaled Corticosteroid (ICS). A LABA is a long-term brochodilator while an ICS decreases inflammation. Rinse your mouth with water after each use, and don’t swallow the water; spit it out. I was switched back to Advair (another LABA +ICS drug), which has bee my usual inhaled corticosteroid. Both drugs are used for asthma &COPD. A Muscarinic Antagonist is also a bronchodilator, such as tiotropium (Spiriva) and aclidinium.

Spiriva, an inhaled capsule, is used for COPD, including emphysema and chronic bronchitis. Later, I was switched to Montelukast, the pill version of Singulair.

There is only one PDE4 inhibitor—Daliresp (roflumilast), and it works against excess bronchitis and phlegm. Daliresp decreases the number of exacerbations in severe COPD, and it’s not a bronchodilator. Daliresp decreases lung inflammation and prevents COPD flare-ups. Don’t use Symbicort, Spiriva, or Daliresp for an acute attack.

For an acute attack, use your “inhaler,” such as ProAir and Proventil; they’re examples of Short-Acting Beta2-Agonists (SABA); both are albuterol. Proair will open the airways and prevent a bronchospasm. You could go for your nebulizer for an acute attack, especially a bad attack. Our albuterol vials for the nebulizer could be called an”extra-strength” SABA. Iprat-Albut (Albuterol & Ipratropium) are two bronchodilators for the COPD patients’ nebulizer. For two decades, I was on pure Albuterol for my nebulizer. Now my inhaler is Combivent–a stronger ipratropium-albuterol inhaler.

Atopic is an allergic reaction, often hereditary. Atopy is a feature of ACOS and associated with a higher prevalence of chronic cough and sputum production, according to Tho, Park, and Nakano. Eosinophilic airway inflammation means there’s a higher than average number of white blood cells. It can be detected in mucus if it’s tissue eosinophilia. Tho, Park, and Nakano note that ACOS patients have higher sputum eosinophil counts than those with COPD alone, but sputum count profiles may change over time. Blood eosinophilia is over 500 in a microliter of blood. I found these definitions at Medicine Net and the Mayo Clinic websites too.  Much of the drug definitions came from the pharmacy’s medicine sheets themselves.

Economic Burden & Disability

Tho, Park, & Nakano note that the percentage of ACOS patients visiting the ER or admitted to hospitals is significantly higher than COPD alone in South Korea. A United States Medicaid population reports that ACOS patients have a higher rate of utilizing any service versus asthma or COPD alone. Moreover, the average annual medical cost for an ACOS patient in the US is $14, 914–much higher than asthma, $2307 or COPD,  $4879. ACOS is common in the elderly. It features more dyspnea (breathlessness), wheezing, and more frequent exacerbations. The respiratory quality of life and amount of physical activity for those with COPD alone.

Addendum to Tho, Park, & Nakano

Using my peak flow meter to check my forced exhale volume (FEV) always has been one of my strong points in managing my ACOS. I check my peak flow meter before I go for a walk, and if I’m under my usual low moderate level of impairment, I head for the albuterol nebulizer. Check my article https://www.newscastic.com/news/forced-exhale-volume-fev-lung-disease-your-peak-flow-meter-1155949/ The “whole story” includes a link to an About.com article on Pulmonary Function tests, by Deborah Leader, RN, COPD Expert.

Returning to the Tho, Park, and Nakano article, we see that a staggering 49% of smokers develop chronic bronchitis and 24% get emphysema or COPD. “Smoker’s cough” is worst upon arising. Dyspnea increases as the disease worsens. Quit smoking or else!

Guaifenesin (Mucinex) has been one of my favorite OTC medicines for years because it’s an expectorant. You can find a cheaper generic version in the dollar store too. Warn the doctor if you smoke, or have asthma or emphysema. It thins the mucus, so it’s less sticky and easier to cough up, according to www.drugs.com/mucinex.html  Take guaifenesin when you have a cold, bronchitis, flu, or allergies–whatever got your chest full of phlegm. Still drink plenty of fluids. www.webmd.com/drugs/2/drug-63818/mucinex-oral/details I’ve been told by my doctor to take a larger than average dose of guaifenesin during an ACOS attack.

I also take an over-the-counter allergy pill, for I’m allergic to Bermuda and Johnson grass. My choice is non-drowsy Loratadine Tablets, an antihistamine that’s another find at Family Dollar. Loratadine is a generic form of Claritin.

Beware of drinks with carbon dioxide (CO2) also, such as beer and soda. http://respiratorytherapycave.blogspot.com/2008/06/asthmacopders-should-avoid-pop-beer.html The ability to exhale carbon dioxide is vastly impaired for the bad lung crowd. “The normal human body breathes to eliminate CO2, producing 200 cc./minute. However, one can of soda has up to 1000 cc. of dissolved CO2. Most is absorbed by into the blood stream by the intestines.” This can lead to more dyspnea (breathlessness) in those with lung disease. Furthermore, beer can cause dehydration too–another cause of dyspnea. Maybe gas pills help; time will tell.

On the other hand, if you like alcoholic drinks and wish to be more careful, then try red wine. First of all, you won’t have to worry about bubbles. Red wine increases antioxidant status and decreases oxidative stress in circulation, mainly because of glutathione (GSH). The “French Paradox” is explained by their love of red wine lessening coronary heart disease despite a fatty diet. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-6-27

In closing, there’s a rich amount of literature on asthma, bronchitis, and COPD. Learn to manage your illness before you continue to deteriorate, and get a pulmonologist if you don’t have one already.

MY MEDICAID ADVENTURE by Joffre (“J.D.”) Meyer

I have had COPD since December 2005 and asthma since 1987. I got on SSDI in March 2010, Medicare in November 2011, and Medicaid in July 2012. Not everyone goes through the same sequence. I checked into a neighborhood nursing home once I got on Medicare, so I could get two long overdue surgeries: hernia since December 2007 and a bad big right toe (either broke or a bunion) since spring 2010. Can you imagine what it was like to hold one’s groin when a COPD sufferer with little medicine coughed for four years?
I made sure that I was affiliated with East Texas Council for Independent Living (ETCIL) when I committed myself. I got a wonderful social worker/relocation specialist, Suzan Chapman, who I still see at downtown art events because her hobby is jewelry, and she’s a fan of the arts and Downtown Tyler too.
Getting out of the nursing home was dependent on getting on Medicaid. Unlike many, I got on SSDI and Medicare on my first try. My last job was a nightmare, so I got lung and mental status testing to be safe, and not end up under a bridge; thus I call my SSDI monthly check, “a bad lung/crazy check.”
While in the nursing home, I went to Pulmonary Rehabilitation at Trinity Mother Francis. This led to attending monthly Better Breather luncheons on second Tuesdays at TMF. It’s a group for those with lung and/or heart diseases. There’s always a guest speaker at our free luncheons.
Turned down for Medicaid the first time, I caught a bus to the records building of East Texas Medical Center’s (ETMC) records department. I provided the records of astronomical E.R. bills from 2008-12 to the nursing home social workers and got out quickly.
I relocated within walking distance from the hospitals in the east-central part of my hometown, Tyler. It’s known as Midtown or the Hospital District. Before checking out, I made sure I was part of Neighborhood Services, so I could get a 2/3 discount on my efficiency. It was great to reunite with a favorite prominent alumnus, Andy Davis, of the HBCU, Texas College, where I’d taught from 2001-06.
Now that I was on the outside, I could have a G.P. and a pulmonologist. I’d always managed to keep my albuterol flowing through my nebulizer since ’97. Having a rescue inhaler is an obvious necessity, but probably tougher now for the strugglers after the end of Primatene, the over-the-counter inhaler that cratered and rising pulmonary illness medicine costs. I started on Advair, the purple disk, while still teaching for the HBCU, but its expense meant sporadic help through service organizations.
My new lung medicines were a tiny pill called Daliresp, and Spiriva, the medicine advertised on TV with an elephant on the actor’s chest. My first pulmonologist prescribed oxygen canula for sleeping. Then the new pulmonologist, Dr. Luis Destarac, noticed my condition was more severe and sent for sleep studies.
Sure enough, I have severe sleep apnea and got a C-PAP machine. The C-PAP helps the apnea condition of waking up off and on unknowingly in my sleep because I quit breathing repeatedly! I bet the C-PAP is also good for the inelasticity of my lungs due to emphysema. Dr. Destarac is also an allergist, so I get allergy shots for bermuda and Johnson Grass primarily twice a month from his also very likable nurses, Esmeralda and Emily.
The G.P., Dr. Paula Bessonette, discovered that I have high cholesterol and require a Lipitor-type drug, as well as Vitamin D. Dr. Bessonette is so cool that she leaves some time open her day without appointments,so she can treat conditions like a COPD exacerbation to keep folks like me from automatically going to the expensive E.R. A recent eye exam caught the onset of macular degeneration, and combination vitamin/mineral capsule is arresting that condition.
My health hasn’t been this good in years–no E.R. visits since early January 2015! I used to go to the E.R. on a monthly basis. I’ve been a volunteer with the East Texas Human Needs Network (ETHNN), starting in the education and health committees before changing to the new transportation committee because I’m an avid bus rider. Then I was invited to the Community Health Worker (CHW) coalition.
Now I’m going through a disability rights group to see if I can have a trial work period, so I can start publishing my Developmental English/Writing textbook–already copyrighted and illustrated. Thus my adventure with Medicaid is about to have a new chapter!

March 3rd #SOL15: It’s Payday!

The 3rd is payday–actually disability check day, COPD in my case. It’s a day of scurrying around to pay bills and buy groceries. I no longer drive. I walk or ride the city bus. I’ve become so well-versed in the bus routes and times that I was recruited to switch to the new transportation committee of the East TX Human Needs Network (ETHNN). Our other committees are education, health, employment, and housing.

My first trip this morning was the Family Dollar to buy really cheap stuff, such as paper products, liquid bath soap, and a bar of dark chocolate–all really a dollar. After a beer stop for later in the day, I visited a former student who works at the cell phone store in the same shopping center. Now she’s married with two kids, some twelve years later after our Developmental English class. I went to her dad’s regional Mexican karaoke a few Fridays ago and sang a couple myself a norteno song and a duranguense song.

Then it was time to watch a compulsory Rockford Files episode–starring the late, great James Garner as a private detective in Los Angeles who lives in a mobile home on the beach. After some rooting around on the Internet with my cellphone alarm keeping track, I galloped to the Purple South bus and headed for Brookshire’s Grocery in Bergfeld Shopping Center–the second hub of the Tyler Transit too. Besides splurging on food, that’s where I get my cashier’s check for rent. Recently, I’ve become a smart shopper who really looks for bargains in the mailbox insert with pen in hand. Sorting heavy groceries into two canvas bags (one lined) preceded the wait for the ride home. I sat next to my new bus friend who was grappling with a scratch-off game.

Once I got home, it was time to lay down with my albuterol nebulizer, while watching news on MSNBC with the volume turned up., for I was exhausted. Then it was time for one more errand before a couple of episodes of “Two-and-a-Half-Men,” in the early Charlie Sheen. Finally, I went to visit friends at Stanley’s Famous Bar-B-Q, and I live just two doors away–really convenient to a well-known restaurant. Now I’m hurriedly typing this Slice of Life while watching J*A*G, the Navy lawyer show.

I prefer living in business districts over residential. My neighborhood is called Midtown, aka. The Hospital District. I can reach stores, pharmacies, restaurants, banks, and doctors fairly easily–even by COPD standards. https://twowritingteachers.files.wordpress.com/2014/01/11454297503_e27946e4ff_h.jpg

Disputing Suicide Advocacy for the Sickly: A Model Essay in Developmental English Textbooks, by JD Meyer

“The Right to Die,” by Norman Cousins: Published by Pearson, McGraw-Hill, and Cengage

Originally published by Joffre (JD) Meyer, Yahoo Contributor Network Nov 7, 2011. Voices.yahoo will end tomorrow; a footnote was added.

Wordsmith-a Developmental English/Writing textbook by Pamela Arlov at Pearson Higher Education-includes “The Right to Die,” by Norman Cousins as one of its model essays in the Argument (Persuasive)/Social Issues categories. This essay is about the suicide of Dr. Henry Van Dusen and his wife, Elizabeth. They had become increasingly feeble over the years and felt that their lives were being prolonged artificially beyond human dignity. Importantly, Dr. Van Dusen had been the president of Union Theological Seminary; he was a famous voice in American Protestant ethics for over a quarter century-hardly your typical case for suicide advocacy. The caption under the article’s title states, “Suicide is traditionally considered a tragedy, even a sin. Under certain circumstances, can it be considered a triumph over a slow and painful death?”

An Internet search shows how popular this article has become. McGraw-Hill offers the essay through Primis On-Line and Cornerstones. The Familiar Essay, by Mark R. Christensen includes “The Right to Die also through Cengage. Cyberessays reports that the states of Washington and Montana passed a Right to Die law in 2009.

Dr. Van Dusen left behind a brief note asking if the individual has the obligation to go on living when all beauty, meaning, and power of life are gone. Isn’t it a misuse of medical technology to keep the terminally ill alive when there are so many hungry mouths to feed? What if there’s nothing left to give or receive from life? Why should an unnatural form of living be considered better than an unnatural way of dying?

Exercising free will can mean suicide, according to Dr. Van Dusen. A call for the exercise of free will is quite common in philosophical and theological literature, and Dr. Van Dusen wrote on free will extensively during his career. Despair and pain weren’t given as reasons for The Van Dusens’ justifying of suicide.

Importantly, Norman Cousins admits that suicide is alien to the theological tradition of the Van Dusens, as it is in most cultures. However, no comment was made in this article about the kamikaze phase in World War II Japan or the current Islamic extremists. The Van Dusens regretted that their children and grandchildren may be saddened and not accept their decision. Yet Dr. Van Dusen believed that theologians and all of us should debate his case for suicide for the terminally sickly.

In concluding, Cousins asserts, “Death is not the greatest loss in life. The greatest loss is what dies inside us while we live. The unbearable tragedy is to live without dignity or sensitivity.”

My initial reaction to this essay was shock that assisted suicide for the sickly would be a topic in a Developmental English or College Composition course, as opposed to maybe an advanced medical ethics or philosophy course. I wouldn’t risk the appearance of trying to euthanize the grandparents of remedial students. Having a disability for COPD (chronic obstructive pulmonary disease) myself makes me a bit squeamish when I hear a call for suicide of the chronically ill.

Once suicide is approved under these circumstances, the cases for acceptable suicide could become extended. What if one felt he or she was too poor to have a dignified existence? The extremely poor can earn as much as $1000/month. Maybe the chronically unemployed or those with a flawed background check could make a case for their own death too. An elderly neighbor feels that there are two unforgivable sins: blasphemy against the Holy Spirit and suicide. Fortunately, the former seems like the most unlikely and esoteric possible form of swearing. My neighbor’s views are probably considerably more common than advocacy for suicide of the sickly.

On another note, adding mullein leaves (gordolobo) to my coffee pot this morning has helped my breathing far more than traditional medicine over the past week–including albuterol for my nebulizer, generic Mucinex, and prednisone. There were also some eucalyptus leaves and whole garlic pieces in that odd drip coffee bin, which had been ineffectual without the gordolobo. At least in Texas, you can buy a package of gordolobo or eucalyptus leaves for $1 each in the Mexican spice and herb section of the grocery store.

Later I stumbled upon a story about the later life of Norman Cousins (1915-1990) at http://www.happinessandlaughter.com/ Norman Cousins was the longtime editor of the Saturday Review and had received hundreds of wards, including the United Nations Peace Medal and nearly fifty honorary doctorate degrees. But in 1965, Cousins became very ill with ankylosing spondylitis, “a degenerative disease causing the breakdown of collagen.” It was believed that the writer would die within a few months, and he was almost completely paralyzed. But Cousins found a way to cure himself, not kill himself; he checked out of the hospital and started taking massive amounts of Vitamin C and watching funny movies! Cousins regained the use of his limbs and he returned to his full-time job at the Saturday Review. Cousins later wrote a book on his ordeal, Anatomy of an Illness in 1979. Thus Cousins chose life over suicide unlike Dr. Van Dusen. I’m glad that Earvin “Magic” Johnson chose life, as today is the twentieth anniversary of his announcement of retiring from pro basketball due to contracting the HIV virus.

Footnote: Originally, I wrote this article for Voices.yahoo, which is discontinuing its services as a citizen journalism website on July 31, 2014. At final count, my 38 articles gained 23,869 reads in roughly six years. This article represents revenge for being told never to disagree with anything in the textbook by a couple of short-lived bosses, as well as not to teach subject-verb agreement for indefinite plural pronouns (others, both, many, few, several) because Wordsmith omitted them. However, a few months before writing this article in early November 2011, I had sent an op-ed to a news station called, “Could Assisted Suicide Lower the Unemployment Rate?”
Fortunately, I changed my mind and have since gotten on Medicare & Medicaid–together with receiving housing assistance. Lately, I go to food banks instead of receiving Meals-on-Wheels. My Subject-Verb Agreement chapter section has received well over 9000 reads through Connexions of Rice University and my Academia.edu website. I’m a Twitter fanatic @bohemiotx with over 1400 followers and a member of two community organizations: East TX Human Needs Network (ETHNN)and the Community Health Worker (CHW) coalition…and hoping for a second career. I’ve never had more wonderful friends, and most of us see each other at Stanley’s Famous Bar-B-Q of Tyler–a regionally known place just two doors down from my apartment in the Hospital District, also known as Midtown.