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ralph robert moore


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ralph robert moore

Copyright © 2003 by Ralph Robert Moore.

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Return to lately 2003.

the shape keeps changing
august 2, 2003

Like a lot of health care coverages, my employer-sponsored plan has a limit on certain benefits, including, unfortunately, speech therapy.

Mary has been receiving speech therapy for over a year, as a result of her stroke in April of 2002.

For the first year following her stroke, her primary coverage was through her own employer. The coverage was great. It paid for her therapy at one hundred percent, no limit on benefits.

After a year, Mary's employer decided to officially terminate her employment (she hadn't been able to return to work during that time because of her aphasia). Her health coverage through them was terminated at the same time. This was not at all heartless on their part. Just realistic. We appreciate they allowed Mary to stay under the coverage as long as they did, one full year after she stopped working.

The result of her coverage under her own employer ending meant that from May 1, 2003 forward, Mary's only coverage for her medical expenses, including her speech therapy, has been through my employer.

My plan, unfortunately, is not as good as Mary's.

My plan only pays eighty-five percent of her speech therapy costs. That seems like a lot, until you find out how much each session costs, and multiply that by two times a week, four weeks a month. Even worse, my coverage only pays one thousand dollars in benefits each year for speech therapy. We exhausted that maximum a week or so after Mary went on my plan.

So we had to make a decision as to what we would do, going forward.

We're not wealthy, we're not poor. We've been living on my salary the past year, and Mary's disability checks, which are only something like sixty percent of her former salary. We obviously have increased medical costs, deductibles and co-insurance, plus on-going drug costs. If we paid for Mary's individual therapy sessions out of our own pockets, we'd incur thousands of dollars in expenses each month. I make a decent salary, but not that decent.

Fortunately, the hospital where Mary receives her therapy also offers a free treatment program for stroke patients and other people with brain injuries. Mary had been participating in it as a supplement to the individual therapy we've been paying for. The director of the free program is very flexible about schedules, and has agreed to provide Mary with two hours of group therapy a week, plus two hours of individual therapy. That flexibility allows Mary to continue to receive the same amount of individual and group therapy as before, only now it's free.

The free sessions start up the first week in September, which means Mary is now on vacation for a month (I'm still working).

This past week has been somewhat busy for a vacation. Mary's poison ivy, which she contracted two years ago, prior to her stroke, has flared up again, bumps on her forearms, bumps on her back (I have to say, I have never known anyone in my life who has so risen above so many adverse situations, with her humor intact, as Mary). We decided to try a different dermatologist, because sometimes it's helpful to get a fresh point of view, and he in fact prescribed some new medications to treat Mary's condition, which has actually evolved at this point into a form of eczema. The new medicines have worked really well, better than anything she received from the old dermatologist. One drug that particularly helped control the itching is the ointment Diflorasone Diacetate, in a 0.05% solution. I mention it by name because Summer is here, and I've noticed, looking at my web statistics, that I'm getting a lot of hits from people seeking a treatment to reduce the itch of fire ants (which I've written about before). Because of its strength, this ointment can be used for two weeks only, and should not be used on the face or the groin. It is expensive, though. Even with our membership in a preferred provider drug plan, our co-payment was still thirty-six dollars for one tube. But if you're desperate for relief, it's something to consider.

The day after Mary's dermatologist visit, we had to herd all eight cats into our attached garage, and we didn't even have to use tiny whips, since they love going out there, it's their backyard, since a guy was coming over from Comcast, Mary's broadband cable Internet provider. Her service had stopped working the previous Saturday, a problem we had once before with Comcast. This time the problem was the same as before, nothing wrong with her cable modem, but instead an issue farther down the street, where the signal is amplified.

The day after that, Mary went to her cardiologist for her monthly blood stick, a blood draw done to monitor her coumadin level.

By yesterday, Friday, all our appointments over, it started feeling like vacation.

We mowed the front lawn early in the morning, before it got hot. You can hear the heat of Summer, down here in Dallas, with that most Southern of sounds, the ratcheting swell and fade of cicadas clinging to tree trunks. By this time of year it's a background noise so constant you stop listening unless someone mentions it, like an air conditioner's hum.

After we mowed, we decided to water the lawn.

There are basically three types of hose sprinklers.

There's the one that shoots out a lateral arc of water from left to right, just above the cut green tops of the grass blades, then snaps left to start spitting again, immortalized in Joni Mitchell's album title, The Hissing of Summer Lawns.

There's the small, humble square sprinkler, which joyously sends up a modest Halleluiah! of water wherever it's laid.

Then there's the best type of sprinkler, a bent-in-the-middle pipe, set within a plastic mount. You lay the mount on the grass, turn on the hose, the perforated pipe unhurriedly rotates left to right, right to left, thin jets of water shooting upwards in a high, soothing display. We use this third sprinkler in our backyard, the jets of water climbing up through tree limbs, curling over high above, below the blue sky, falling in a thousand leaf-bending drops, birds and butterflies swooping through. When you run under the dripping trees, back hunched, to adjust how the sprinkler lays on the ground, it's like scurrying through rain.

That's the sprinkler we started with on the front lawn, because it covers a wide area, like a rented cloud, but it soon developed the problem this type often does, of getting stuck in one slanted position, so that one thin arc of your lawn gets really, really soaked, but the rest stays parched. If you stand directly above the malfunction, you can even hear the tit-tat, tit-tat jam of the gears repeating with the annoying regularity of an eye tic.

I tried a number of methods to fix the device: (1) spraying it with WD-40; (2) repositioning it on the lawn; (3) turning the water source off, back on; (4) standing near it, doing nothing, listening to the tit-tat, tit-tat while the bottoms of my trousers get wet; and (5) saying "Fuck!" in a loud, despairing voice (this last method has never yet worked, but is still being tested).

None of these attempted solutions achieved their purpose.

Finally, we went in the backyard, unscrewed the afore-mentioned second type of sprinkler, the modest square one, off the backyard hose, carried it through the house, out the front door, screwed it on the front yard hose.

It worked as it always does.

Hours later, because you can only cover a much smaller area of lawn with the square sprinkler, we were finished. Each time we had to reposition the square sprinkler, I didn't go to the outdoor faucet against our home to shut off the water so we wouldn't get drenched, but instead simply twisted a length of the green hose, which had the same shut-off effect, an idea that had suddenly occurred to me, in response to which, the first strangulation, I saw Mary rear her head up, with one of those, Clever you! looks.

The lawn soaked, I stood on the front door side of the lawn, too lazy to walk over to where the square sprinkler had last been placed on the side lawn, instead simply picking up a length of wet hose, pulling more of the length towards me, reeling the heavy metal square across the concrete of the driveway, where its start, stop scrape across the concrete, heavy and hollow, for some reason made me think of how happy I am, and how much I love Mary.

Because of the change in our health coverage, this past Monday, July 28, was Mary's last day with her regular speech therapist (the one we have to pay for).

We've been seeing the therapist since late last year. She's a wonderful person, and has helped Mary tremendously with her speech. She herself, as it turns out, will be leaving soon anyway, since she's pregnant and she and her husband have decided she'll stay home after she delivers.

Mary created a gift for her, an oval box with a puppy and kitten painted on the lid (a photograph of the finished box appears at the end of this Lately).

At one point during Mary's final session, while the three of us were sitting in the small office where the speech therapy takes place, there was a knock, the door opened, a middle-aged woman bent her head in just long enough to sing out a cheerful good morning, hand the therapist an aluminum foil covered plate. "Just some brownies I baked!"

"She's such a sweetheart," the therapist told us.

I asked, "Is she one of the new therapists?"

"No. She's a patient, actually." I was surprised. "She was in a terrible traffic accident. Most of her face was crushed. She's had about three cosmetic repair operations. You'd never know how bad she was, looking at her now."

Indeed I wouldn't, in part because of that cheerfulness, that refusal.

"Her husband died in the accident. He was driving the motorcycle. They were married for thirty years."

Love is invisible. A shape you can feel, but the shape keeps changing.