Life has gotten in the way of posting lately, what with various infections landing me in the hospital, freelance deadlines, student papers, starting the lovely process of selling one home and buying another…But in the midst of the pre-Thanksgiving log jam, I found this little anecdote highly amusing:

We had a home inspection scheduled for the same weekend I ended up in the hospital. We told my parents that we were bringing in a structural engineer to look at some issues that came up during the inspection, but between coughing and not having a voice and the general craziness of rapidly declining health, I hadn’t mentioned this development to anyone else. A well-meaning family member called my mother to see what was new with me. My mother replied,

“Well, the structural damage isn’t quite as bad as it could have been.”

Confused, the other family member was left to ponder if she was referring to me or to the house. I was the obvious choice, and he felt confident in his selection.

“No, no, I’m just as structurally defective as ever,” I said when he relayed this to me.

Silence.

“But it’s okay. I would have picked me, too.”

***

As I told my editor this week, I think I got my end-of-semester illness out of the way early this year. Ok, it’s still lingering, but I remain optimistic. For as long as I can remember, (we’re talking nursery school here) November and December have always been plague-ridden months in my world. When I was in grade school I always had surgeries right around this time—a few times on Christmas Eve day, even—and throughout college I always wound up in the hospital near or during finals.

Awesome timing.

In the dark days of misdiagnosis, when my doctors were scrambling to figure out why my lungs got worse no matter what they did or how many steroids I took, they were wont to ply me with this: “Are you sure you’re not stressed out? Maybe stress is causing all these exacerbations.” Because we can’t figure out the real problem, we’ll put it back on you.

As calmly as I could, I explained time and again that being stressed did not make me sick. Being sick and knowing I was then going to fall behind in studying for finals and miss all the end-of-semester festivities? Now that made me stressed. They had it backwards.

Know what I mean? I’m not foolish enough to say that stress doesn’t make health conditions and situations worse. Of course it does, and of course it has for me. But it’s a cop out for someone to say stress is the cause of illness simply because he or she can’t find an obvious answer and isn’t willing to dig deeper to find the correct one.

I never backed down from this assertion that they had it in reverse, even when I missed both Thanksgiving and Christmas one year because I was in the hospital. Luckily, I now have doctors who know that the reason my lungs don’t respond to asthmatic protocol is because my problems are not caused by asthma. (Cue resounding duh here). But I have been thinking a lot about this time of year, and why it’s usually such a disastrous period of time.

It’s really not that complicated. It’s cold and flu season. More people are clustered indoors because it’s colder out. There are more social engagements to keep us out late, and more errands and cleaning and cooking to do on weekends when we would normally have some downtime. There’s a crunch to get big work projects finished before year’s end, so even though we’re out later and more often, we find ourselves getting up earlier. And no matter how healthy we are otherwise, the more run down we are, the more susceptible we are to the many infections that travel around this time of year.

Somehow, this seems like a much more plausible explanation. And it is one more reason why I have never backed down.

“ I just wish I had some better options,” a colleague said to me recently. She wasn’t someone I knew well, and it started out as one of those casual “how are you?” kind of talks.

At the beginning of our conversation these are the thoughts that ran through my mind: I hope it’s not still raining. My throat is burning, I think I am coming down with something. I am way behind on my novel’s word count. Ouch, my throat is really burning. Do I have a fever?

I listened, at first exchanging pleasantries and then nodding in commiseration with her plight, even though I couldn’t really commiserate.

“You see, it’s like I have to choose between paying the rent and health care,” she said, an untenable position made even worse by the state’s new health care law. “I need a place to live so I pay the rent, but then I go into more debt for the health care.”

That’s a pretty lousy choice to have to make, particularly since it really isn’t even a choice. You need somewhere to live, and if you’re sick, you need medical attention.

I turned away a little to cough and when I faced her again my face felt flushed. Perhaps it was from the cough, or the fever that would ultimately knock me down for several days, but I also think it was from that squeamish uncomfortable feeling that comes with knowing you are a “have.”

And someone else is a have-not.

In a way, it all boils down to options. I could never imagine the possibility of paying for my care out of pocket, because the expenses would grind me into the ground almost immediately. It simply wouldn’t be an option for me.

But what if it had to be?

This is an intensely political issue, but I am coming at it from an emotional perspective here. I have sighed when I’ve written large checks for hospital bills, cringed when I’ve needed new medications that are expensive, and I’ve watched with a mix of indignation and sadness as coverage of my daily chest PT sessions—the preventative care that does much to prevent prolonged (and costly) hospitalizations—have been cut down further and further the past three years.

I find many things confounding and unfair about our health insurance system.

And yet that on that cold, rainy day when I knew I was definitely getting sick, where I coughed and wheezed and listened as my colleague said she may have to move of the state because of its prohibitively high cost of living, there was something else I felt. Something besides the jarring cough, the first flush of fever, the awkwardness:

Relief that I did not have to choose between my house payment or my health payment. Gratitude that while my coverage has decreased over the years, I am still covered. Gratitude that when I went home that afternoon—I wouldn’t be able to leave the house again for several days, as it turned out—I would have a supply of medicines and treatments, a doctor who was just an e-mail away. I would have options.

Since I wrote this post on watching someone you love in tremendous pain, I have been thinking a lot about gratitude, and the mix of emotions that come with it. I hate that someone I care about is suffering, but I know I am lucky I do not have her pain.

Likewise, I may have lungs I would classify as dodgy on their best day and down right contrary on their worst, or an immune system that’s about as good a defense system as an unlocked door adorned with a “Come on in” sign, or an endocrine system that is routinely haywire, for example, but (you knew a “but” was coming, right?) this is not all that I have.

I have legs that may hurt sometimes but get me where I need to go. I have a healthy heart and good blood pressure and when I go to the gym and feel my muscles work, I am proud of them. I have many parts that work well. I also have a network of people who love and support me, who watch out for me, who ferry me tea when I cannot stand and who encourage my greater goals when I am scared I will fall down.

Someday I will write a post about the current state of our health insurance system. Maybe I’ll even commit to a course of action for trying to resolve some of these glaring problems, because with each word I type I am conscious of the many, many people would not be in the position to say this:

I have options.

Dayna at A Bug’s Life is a new reader of mine who not only runs a wonderful blog about parenting children with chronic illness but also tagged me recently with another Thinking Blogger Award for this post—thanks so much!

In the spirit of discovering new blogs, the five sites I have selected for Thinking Blogger Awards are either fairly new to me, fairly new to the blogosphere, or both:

Hemodynamics: Joe is a first-year intern in a large academic hospital. He also happens to be an eloquent writer who contributes to NPR and is writing a book, among many other pursuits. Check out what a powerful combination that is.

Sick Momma: Aviva is a longtime journalist who is now a stay-at-home mom. Or she was, until a serious illness suddenly took over her life in June of 2007. Now’s she on a path to figure out what’s wrong with her and make some sense of all the changes—and she does it with honest, engaging prose.

I’d Like to Buy A Vowel: As you can see from her blog’s name, Alicia approaches living with a not-so-funny chronic illness with witty, sarcastic aplomb, and her musings are compellingly universal yet specific to her. You’ll love the voice here.

A Medical Mystery: JC might have a rare disease and her fair share of medical mysteries, but she’s also got a good sense of humor and a lot to say about being what some people have called “that girl with the bone thing.”

Respiratory Therapy Cave: Freadom is a respiratory therapist. RTs are a huge part of my life, both inpatient and outpatient, and it’s really interesting to see the perspective from the other side—especially when the writing is thoughtful and honest.

For the winners:
1. If, and only if, you get tagged, write a post with links to five blogs that make you think.
2. Link to the blog so that people can easily find the exact origin of the meme.
3. Proudly display the “Thinking Blogger Award” with a link to the your original post

How to Cope with Pain will now be offering a monthly pain-blog carnival. Each edition will run during the last wek of the month and will feature that month’s “best posts” from featured bloggers, including A Chronic Dose. Definitely check it out, and new bloggers are always welcome to contribute!

While we’re on the subject of taboo-breaking, consider this: Paul Levy, President and CEO of Boston’s Beth Israel Deaconess Medical Center (a place I know well) recently started a blogging. Running a Hospital discusses (you guessed it!) issues of health care policy and practice in running a hospital. It is a fascinating read, and is causing somewhat of a stir–how many hospital CEOs do you know maintain a public blog?

He hosted Grand Rounds this week-check it out here.

I don’t have too many insights on chronic illness this week. I’ve been sick, the malingering, annoying, infection-y kind of sick, and well, there’s really not too much to say about it. It’s just an occupational hazard. Plus, with the book wrapping up soon, the hometown team on a World Series streak, and the upcoming NaNoWriMo, there have been plenty of distractions.

So I’m looking outward with this post, and can’t help picking up the topic of social networking and medicine another time. As discussed here and throughout the medical blogosphere, there are many benefits to the merging of medicine and social networking: Patients can connect with each other and share insights and information and practitioners can exchange tips and resources.

Between Facebook, MySpace, and LinkedIn, there are all sorts of ways for people to connect personally and professionally. It makes a lot of sense to me to have a site specifically designed for physicians, one that allows them to discuss techniques and best practice information and doesn’t require them to use their full names—enter Sermo.com, a Cambride-based social networking site for licensed physicians. After all, as this article points out, doctors are usually more focused on discussing treatment methods than the traditional networking business people do.

Since it launched last year, Sermo has attracted 25,000 physicians. I consider this trend to be largely beneficial—if our physicians are flummoxed by a set of symptoms or want to bounce ideas off of colleagues who specialize in their field, then providing them a space to do this gives the patient the potential for better outcomes.

What’s interesting about Sermo is that it is financed by hedge funds and other companies who have access to the discussions physicians have on the site. This allows them to track trends and controversies in the medical field and the doctors’ names are kept anonymous.

Like many discussions that involve pharmaceutical companies and their interactions with physicians, this interesting financing approach has the potential to become controversial when you add Pharma to the mix.

As reported in this article, drug giant Pfizer recently announced it will partner with Sermo. This arrangement will give the drug manufacturer—which laid off 20 percent of its domestic sales force in 2006—another direct route to reach in the hopes learning more about prescribing preference. Pfizer-affiliated doctors will be able to speak candidly with Sermo users, something that is either smart marketing or seriously worrying, depending on your point of view. Some think it’s a better alternative to swarming physicians with office calls, but others worry about the far reach this latest extension of social networking affords pharmaceutical companies.

So what do you think? As patients, does knowing that a large drug company will have unprecedented access to physicians make you nervous, or do you see it as an inevitable and positive technological step?

In other medical technology news, I came across this tidbit in Newsweek: the Cleveland Clinic has introduced a program called MyChart, which allows patients to access their online medical records through a password-protected site. The hope is that this access will mean better self-care and disease management, and preliminary results are promising: diabetics who used MyChart showed better control of their blood sugar.

At first glance, what Newsweek calls a “taboo-breaking initiative” (and I don’t disagree with that assessment) seems both positive and forward-thinking, harnessing the power of technology to help patients take control of their health. But a discussion in one of my classes got me thinking about the other potential outcome of this—what about those patients who would receive more harm than benefit from unfettered access to their medical records? One example that comes to mind are patients with eating disorders who are too focused on their weight and might get worse if they see numerical evidence they have gained any pounds.

Obviously I’m not sure what kind of safeguards or restrictions on use are in place, and I do think the precedent set by MyChart is a significant one. But in a world where so much can change so quickly, it’s also helpful to play the devil’s advocate now and again—especially when we’re talking about our health.

If you want to listen to it, you can find the audio file for the Get Real Girls Interview on the sidebar at the right, conveniently located in the newly streamlined “Select Publications and Publicity” section. I tested the file on a Mac and a PC and it worked fine on both, but let me know if you have trouble with it. A Barenaked Ladies song fills the first few seconds and is the lead-in to my segment.

You can also find the brief feature on me and link to the entire show at 107.1.com.

I’m branching out a bit: To my surprise and pleasure, I was contacted this week by the co-host of Get Real Girls, a popular weekend radio show that airs in Minneapolis on FM107.1 and online at EatBetterAmerica.com. The show is devoted to helping women live their lives with intention and purpose. This weekend, they are focusing on letting go of guilt, and after reading an essay I wrote that appeared on Chronic Babe, they selected me as the Get Real Girl of the Week.

The interview will air this Saturday and can be found on 107.1.com, where they also have a brief feature on me.

I promise I will try not to talk too fast. This is no small promise.

Many thanks to Jenni Prokopy at ChronicBabe for giving A Chronic Dose its second Thinking Blogger Award, and congratulations on her own much-deserved recognition.

UPDATE: Before you delve into the blogs listed below, I wanted to update you with news regarding my friend Jenni at ChronicBabe, whose home was destroyed last week during the heavy storms that struck Chicago. To read more and see how you can help, visit ChronicBabe.

Now it’s my turn to select five blogs that make me think, make me question, and otherwise enlighten or inspire me. There’s a lot of great writing out there, so this isn’t an easy task. With no further ado…

Susan Palwick at Rickety Contrivances of Doing Good is an acclaimed sci-fi writer, an English professor, and a volunteer ER chaplain— a dynamic mix indeed. She’s a thoughtful, engaging writer with a perspective well worth reading.

Tiffany at Sick Girl Speaks has quite the long medical history under her belt, but her mission is much simpler: to be a patient advocate to the healthy world. No one’s seen more of the medical institution than Tiffany, and her insights are both spot-on and unflinchingly frank.

After the MFA starts by posing the question that makes all MFAs cringe a bit: So, now, all of a sudden you’re a writer? For anyone thinking about getting an MFA, working towards one, or anyone has one and has no clue what to do with it, check out this site. It’s informative, witty, and doesn’t sugarcoat.

Tracey at More Than a Minivan Mom has lots to say on all sorts of topics, and her opinions are as interesting as they are honest. Plus, she’s about to embark on a career that’s especially close to my heart: working with pediatric patients (specifically, kids with cancer).

Michelle Richmond at Sans Serif is a best-selling author and her thoughts on writing, reading, and “bookly ephemera” are compelling.

Here are the rules for winners. If you choose to participate, please make sure to pass the rules on to the next Thinking Blogs you tag!:
1. If, and only if, you get tagged, write a post with links to five blogs that make you think.

2. Link to this post so people can easily find the exact origin of the meme.

3. Optional: Proudly display the “Thinking Blogger Award” with a link to the post that you wrote.

* This award was started by Ilker Yoldas at The Thinking Blog

I know you’re out there, loyal readers. I have a simple request of you: the time has come for me to do a better job managing my site traffic, so I’m changing things up a bit. Bear with me. I’ve added a handy-dandy e-mail subscription service–located at the top of the sidebar info on the right–and I’m hoping you’ll take a couple of seconds and subsribe to my posts that way. Thanks so much!