Health Insurance, again!

I'm officially enrolled now, with benefits beginning tomorrow.  After losing my disability benefits last year at this time I also lost the health benefits associated with them.  We were forced by circumstances to go onto my wife's employer's health benefit plan, which had no mental health benefits.  Needless to say, it was a bit of a worry for someone who has an active mental health diagnosis to be without mental health coverage.  That changes tomorrow.

I received a call to serve half time as a "transitional minister" at Peace Lutheran in Otis Orchards, and my package does include participation once again in the Church's insurance program.  Quite a relief.

There will be a few hassles.  For example, today I began the process of getting my meds cleared for coverage.  I will have to get pre-authorization for them, and my physicians will have to go through the step procedure protocol, explaining to them that I've already been on all the cheaper meds and they didn't work.  Hopefully this will all sort out in short order.  But the good news is I do have coverage once again.

We are particularly grateful for the timing of all this.  After quite a few years with her employer, a change in management and concerns regarding her own health led Karla to the tough decision of having to resign her position.  The health benefits we were receiving terminated Sept 30.  There will be no gap in coverage, as my benefits resume Oct. 1.  There are times in life that I'm overwhelmed with the conviction that God is taking care of us.

And then there are also moments when I'm filled with a certain fiendish delight.  Having had my disability benefits terminated in an abrupt and disconcerting fashion there is part of me that feels a bit like "I'll show you, I'll take a call, and then you'll have to cover me again!"  Yup.  Now they can pay for the meds, and psychiatric bills, etc., etc., that they stopped paying for when they terminated my benefits.  "Hello!, Remember Me!  I'm back."

Those moments are short lived.  

Mostly, I'm just grateful for health, and insurance to pay for maintaining that health.  Were it not for insurance I wouldn't be able to afford the meds, and who knows what would take place.  I think of the homeless and recognize that many of the homeless are homeless because they are mentally ill, and not able to receive proper treatment.  Could a similar fate have befallen me were I not so fortunate to have been covered by insurance throughout this journey????  I have a family I could have leaned on, but would I have?  And without insurance could they have offered enough help?

This is one of the reasons that I believe that there should be universal health coverage in our country.  Sick people can become an incredible burden on society.  Keeping them well, and able to work, is much better.  At anyrate, I'm delighted to sing "Hi Ho, Hi Ho, and off to work I go."

694

I was blown out of the water this morning.  As I opened up my other blog page, wanderingsthroughtheword.com the statistics on the home page surprised me.  Over 700 page views this week.  A little research and I discovered that 694 of those were from the nation of Israel.  

I had written a post about Psalm 137.  Perhaps that's what stimulated the surge in readers.  I don't know.  I wonder though.  My mind races.  And I am ever conscious of my own manic tendency toward a 'savior' mentality, and/or 'grandiose' thoughts.  

This is the way that works.  A simple fact that there were 694 page views from Israel.  It could be that something I wrote simply was picked up by the Google search engine, and resulted in the hits.  Did 694 people in Israel do a Google search on Psalm 137 and my post came up?  Could be that simple.  

But then I begin to wonder who those 694 people are.  Are they Christians, Jewish, or Muslim?  And is what I'm writing resonating with them.  From that my mind moves toward the question of ministry.  Have I stumbled into a new calling?  Has my blog become a platform for my own foreign missionary work?  Most of my page views come from the USA.  A sizable amount have come from Israel, and almost as many have come from the Ukraine.  
And then I wonder how I might make a significant difference.  My mind races. . .

Rein it in, Dave, rein it in.

I am not Israel's savior.  I am not destined to be the next Billy Graham.  

And then the verses come to mind, shared with me many years ago by a patient I came to know when I was serving as a hospital chaplain:

So shall my word be that goes out from my mouth;

it shall not return to me empty,

but it shall accomplish that which I purpose,

and succeed in the thing for which I sent it.

Isaiah 55:11

This is the thing.  Amid all the concerns that I might be headed in the direction of mania, there is this hope that to the extent I am a minister of the Gospel, God's Word, not mine, might have an impact in the lives of those who hear it.  I am not the savior (as my manic side would like to believe), but at the same time there is a Savior, and of him we bear witness.  

One final thought:  Could it be that God harnesses and uses the gifts of bipolar people for the sake of a bold witness to the world?  Can it be that this disease that could destroy me, might also be a gift to empower me?

A second 'final' thought:  Coming out of depression does not necessarily mean that a manic episode is imminent.  It's quite possible that an extended period of mood stability and a healthy balance is actually what is being experienced.  That would be alright.

Daring to have Joy

When mood swings are the problem, then one's tendency is to be concerned when one experiences either the highs or the lows associated with this disease, bipolar disorder.  Treating depression is a no brainer.  No one wants to feel that way.

But the struggle is what do you do at the other end of the spectrum?  

Currently, I am not depressed.  There is part of me that believes that thanks to the effectiveness of my medications I am at a point of a healthy balance.  I feel joy, yes joy, pure joy, in a way I haven't for years.  I catch myself smiling.  And wonder what's up.  Its been a while.  

Our lives are changing.  Over the last few years I've been limited in my ability to work and earn a livable wage.  We've been dependent on my wife's paycheck and my disability benefits.  Those stopped last year at this time, and a job opportunity opened up for me at a cabinet shop.  Today, I am anticipating resuming my pastoral ministry.  In addition to my work as a cabinet maker I will be serving a small congregation on a half time basis.  

This is a Godsend for us for it comes at a time when due to a variety of circumstances my wife chose to resign her position and is now unemployed.  For the time being I am the sole breadwinner in the house-- and it feels good for my ego.  Not that I delight in my wife's situation, but just to be here, once again, where I am earning enough to support my family is a good feeling.  Joyful, even.  

Energy is bubbling up inside of me.  I am planning on working close to full time at the cabinet shop, and half time in ministry.  Sounds like a lot, but the actual hours will be similar to what I often worked in ministry alone.  Most notably, as opposed to when I was disabled by depression, unable to even shower without effort, I now am quite convinced that I can do this.  And enjoy this.

The problem is that highs can be too high.  I have to be careful.  I have to monitor myself.  The call to return to ministry is neither a call to be a savior, nor to grandiose endeavors and quests.  Mania feels good,  too good, and one must guard against it and be wary of it.  

But what becomes of joy in living?

Exuberance.  Can we experience that without fear that it will give way to mania?  

One of the concerns I have is that fear of mania will deprive me of the opportunity to enjoy normal states of joy and delight.  I am convinced that I need to overcome that fear.  There are things that one can enjoy, without reservation, even if one is bipolar.  

And so I will march onward.  One day at a time.  And simply be thankful that the clouds of depression have lifted.  And pray that the other extreme is not looming near on the horizon.

Journey into the Bottle

Its a very common problem that many people simply do not understand.  Why do people become dependent on alcohol, lose control of their lives, often coming face to face with death, and then, in spite of everything that would shout out "Stop!", find themselves quite incapable of stopping.  

My views on alcoholism, or as I prefer to call it, a chemical dependency on alcohol, are rooted in my own personal experience.  As opposed to some, who from the first drink on were out of control, I drank moderately, and sporadically for most of my adult life.  Specifically, I could have a beer or two at times when it seemed appropriate, and then not have any for significant periods of time.  Football season was a time I liked a beer.  Beer and pizza was good.  But then as the weather turned cold, I had no interest in a cold one.  It might be months before I'd have another.

I might drink heavily when I was away at the pastor's conference.  And then nothing.  I could take it or leave it.  This was my story from the first drink I took when I was 18, through about my 45th birthday.  

And then things changed.  

Two things, actually, impacted my journey into the bottle.  First, I was prescribed Ativan as part of my medication in treatment of my depression and anxiety.  Ativan (lorazipam) is a drug that works in your brain in a similar way as alcohol, same receptors, so I am told.  It is highly addictive.  I decided to go off of Ativan and did so, virtually cold turkey.  Almost to the day, without realizing what I was doing, I substituted a couple of drinks a day for the Ativan I was taking.  This is classic "cross addiction".  I simply changed substances.

The second major contributing factor in my drinking, was that I began to drink for effect.  I needed it to sleep, to ease my tension and anxiety, and to relax from a day's work and stress.

The net result is that I went from an average of one or two drinks per week, to consuming 6 to 7 fluid ounces of Scotch a night, and this change happened almost immediately.  It didn't happen over the course of years, or months, but within days.  

There are three stages of addiction.  

When one first introduces alcohol into your system the body reacts negatively to it as a foreign substance.  Intoxication is the result.  This negative reaction of the body is found to be repulsive by some, and enjoyable by others.  My wife has never been able to tolerate even the smallest amount of intoxication.  I rather enjoyed the "buzz".  But whether one finds intoxication to be repulsive or enjoyable, it is the body's profoundly negative reaction to alcohol in the system.

When alcohol is consumed regularly, in sufficient quantities, the body does its best to adapt.  This is called "habituation" or building up a tolerance to alcohol..  The body re-regulates itself to adjust to the presence of alcohol, with the net result that alcohol begins to lose its intoxicating properties.  For those who desire the effect of intoxication, they must drink more to achieve the same results.  And the body continues to adapt, and more is still needed.  An advanced alcoholic can consume an incredible amount of alcohol, and still function normally.  If you have to ride in a car with a driver that has been drinking, pick the alcoholic.  

The third phase of alcoholism is that it becomes necessary to maintain a level of alcohol in the system to feel "normal".  I used to joke that it took two Scotch doubles just to feel sober.  It was no joke.  It actually did.  At this point in an alcoholic's life intoxication is no longer the problem.  The problem is detoxification.  The body has so adjusted to a constant presence of alcohol in the system that it now reacts negatively to the lack of alcohol.  Case in point:  As my drinking reached significant levels, I began to worry about my congregation smelling liquor on me Sunday morning, and so I decided not to drink on Saturday nights.  The result, which I did not recognize, was that Sunday mornings I began to shake uncontrollably, enough that I could not pour the wine during communion distribution anymore.  I thought to myself that this had nothing to do with drinking, because I hadn't had anything to drink.  My body, however, was detoxing.  It was having an adverse reaction to the lack of alcohol.  At this point, the addiction to alcohol is at its strongest.  One MUST drink to avoid the negative effects of detoxification.  Its a simple matter of pain avoidance.

But there are limits.  An alcoholic desires to feel that pleasant buzz, but now doesn't.  And so they drink more.  The "buzz" is gone.  On my last night drinking, I consumed over a fifth of Scotch, plus took Ativan, to calm my nerves and hopefully, experience the 'positive' feeling of intoxication.  It eluded me.  I nearly drank myself to death in the attempt.  

I believe that this cycle of intoxication, habituation, and detoxification is a pattern that anyone will experience given the consumption of enough alcohol on a regular basis.  No one is immune.  Some  people may be more prone to alcoholism than others, for a variety of reasons.  But I believe that no one is immune.  No, not even one.  Be aware of that the next time you think to yourself that you can really 'handle your booze'.  That may be a sign that you've just advanced to the second stage of alcoholism, and what I can tell you from personal experience is that it does not get better from there.

Sifting through Advice

Having received the report of the psychologist that recently evaluated me, I find myself seeking discernment.  What do I make of it all, and how can I best utilize the advice offered there.  I've already shared that there are some things that came out of this process that I am, oh shall I say, humored by.  That my number one vocational choice, according to one test, is to be a librarian floored me.  Not on the radar screen.  Nope, no way, no how.  

There are other suggestions within the final report that seem good on the surface but which are easier said than done.  Re-evaluate the condition of my knees, considering a second opinion, to the end that I might pursue an intentional exercise program to reduce stress.  OK, so that sounds good enough, but a psychologist's opinion about the state of my knees pales in comparison to the agreement of two orthopedic surgeons, one of whom operated on me.  I have a degenerative condition.  The old knees are going to continue to get worse.  The menisci are wasting away.  Eventually it will be bone on bone.  In the mean time I've been told to hold off as long as possible, and then will come the process of injections, followed by knee replacement.  It makes extensive exercise a challenge.

Its not that I'm adverse to exercise as a means of dealing with stress, cardiovascular health, or even my depression and insomnia.  I used to walk hours at night to unwind.  Just ask the people in Baker and Thompson Falls, some of whom called the police to report the "prowler" walking the streets late at night.  I probably logged ten miles a night during those times, even in the dead of winter.  

The struggle now is that I have a choice.  If I exert myself with exercise, my knees are so sore that it is difficult to make it through the next day's work.  One activity pays the bills, the other doesn't.  You choose. . .

I will have to admit that I also take the importance of intentional exercise with a grain of salt.  You see, when I was working a desk job, the importance of physical exercise was pretty straight forward.  Today, I'm putting in 10 hour days doing physically demanding labor.  I may not be "exercising" but I'm quite physically active.  

The importance of reducing stress is not lost on me though.  Its just that there is more than one way to skin a cat.  Walking may help cope with it, but I've found getting at the root of it is even more important.

One development that I wouldn't have predicted is the effect of "diversifying my portfolio", to coin a phrase.  Necessity required that following my resignation from my last call, I find ways to survive financially.  For a while I had disability benefits, I was working at my own business, and thankfully, Karla had a good job.  When disability benefits stopped, I was able to find a job in a cabinet shop, which together with the business and Karla's work, met our needs.  And currently, I have also received an offer to re-enter ministry on a part time basis.

The net result is that our livelihood is no longer dependent on any one thing.  Our eggs are no longer all in one basket.  I am amazed at how much that has reduced the stress that I experience.  There will be something to fall back on if changes should occur.  

All this is to say, that some very good goals came out of the evaluation (being a librarian, excepted!!), but how I pursue those goals may be different than suggested.  But then, that's what discernment is all about.