Commemorating my first sinus infection with no insurance!

Hello, all~

Apparently the nasty head colds I have had in succession through all of January and February were in reality one on-going sinus infection!

So this post may not be as scintillating as usual. I'm still feeling somewhat out of it.

But I wanted to share with you, dear readers, what one does in Portland when one needs antibiotics and can't afford to go to the doctor.

I have been careful ever since I was booted off my parents' insurance when I was 22 to find employment that would give me insurance. To hell with those independent small businesses, and Hello, Starbucks! Hello, AAA! I haven't had the traditional early-twenties sense of invincibility--as many of you know, I've been sick a lot. Often mysteriously, sometimes seriously, fairly frequently. Anyone interested in the gruesome details probably already knows them, so I will refrain from mentioning them here.

Anyway, after pondering it for awhile, Ian and I finally made the decision that I should go to part-time. Last year I ramped up my insurance coverage from the less-expensive Kaiser Permanente HMO to Providence, which costs twice as much, but let me choose a doctor. At Kaiser the doctor lets you get about 30 words out of your mouth before they just stop listening. If you are lucky you convinced them to prescribe you something before they hit their saturation point.

Even after a year of improved care, however, I have been dealing with fatigue and anxiety, and existing on the very edge of my sick-time limits at work. While we didn't want to give up our insurance, we both knew that I really needed a rest in order to regain the health that I had never fully regained after my freshman year of college. Anyway, there's the background of our choice to give up our health insurance. Hopefully it's enough to assuage the conscience of any acquaintance who might otherwise feel the need to remonstrate with us for this decision. Never fear, I've let you off the hook.

And, of course, Murphy's Law being what it is, we both had to get sick over New Year's. Sudden nasty cough and mysterious fever--Ian's went to 103 degrees. Presumably this left me no resistance for the sinus infection that then elected to take up long-term residence with me.

So, what to do?

First, of course, I attempted a regimen of every [well, say half] of the naturopathic remedies known to man. Quantities of orange juice. Liquid echinacea, liquid goldenseal, washing out my head with salt water, 'Wellness' pills to build up my immune system, lots of rest. [Later on I will do a post just about 48 hour Zap a Cold and the Devil's Smoothie, which can often conquer illness, and which I swear by, as a general rule.] All these efforts were for naught, however, and when in mid-February, a sore throat and congestion returned suddenly, in the middle of an afternoon when I'd finally thought myself to be on the upswing, I knew I would need an antibiotic.

So I did a google search on "sliding scale clinics Portland Oregon" and found a couple of lists of "community clinics." Many of the options were for categories like, "Slavic adults and uninsured adults on Thursdays 7-9 pm."

There was one close to my home, in North Portland, but it only accepted patients under 21. Another one, on 39th & Division, was also close, but then I saw that it accepted only "patients living within designated service area in SE Portland." I--unfortunately, for this purpose--live in NE Portland. Still another helped only residents of the West side [downtown] or the homeless. Another was open on Thursday evenings for dermatology and podiatry only.

So I looked at a couple of the more mainstream-looking ones; regular doctor's offices that also accepted sliding-scale. They at least were available 40 hours a week instead of one Sunday a month The first one, a clinic called Rosewood, said they could "start the process," when I called them first thing Wednesday morning. I asked hopefully if there was any way they could fit me in today, thinking that at worst it wouldn't be till early the next week. "Oh, no," the receptionist said disinterestedly, "the earliest opening we have is in mid-March."
"But I need urgent care!" I said.
"I'm sorry, it always takes at least a month to process," she said.

So I called a second clinic, the Portland Adventist one. I was born at Portland Adventist, and for some reason that gave me high hopes. The lady there was friendlier but explained that they certainly couldn't fit me in before mid-April.
"There's no way?" I said. "I'm pretty sure I have a sinus infection, and if so I've had it for nearly 6 weeks already. And it's only getting worse."
"Maybe you could try Rosewood?" she said.
I told her about the wait at Rosewood.
"Well, how about Outside In?" she said.
"Yeah, I was going to call them next. Thank you," I said.



I had decided that Outside In was a last resort. I knew a little about them--early on in college I had considered volunteering for them, but their application made such a point of needing to be pro-choice [at the time I was unreservedly pro-life] that I wasn't sure I would be a good fit. I knew, too, that they had been wonderful to a friend of my sister who had been homeless in her late teens. But I knew their primary focus was homeless teens, and providing needle exchanges and so on, and I just didn't feel that I had the right to be there, claiming their time when they were helping people who were in straits considerably more dire than mine.

I read the guidelines carefully: "Focus on Homeless, Youth & IV Drug Users. Clinic will serve anyone who is low or no income, uninsured with an emphasis on people under 30 yrs of age." I still felt embarrassed. Did I count as "low income"?--I make a fair amount more than minimum wage.... I decided that I had had enough cold-calling for the day and waited for Ian to get up, so he could call them for me.

The person who answered the phone at Outside In told Ian that it was slower in the mornings, and that if they thought we made a lot, they'd just charge us more according to the sliding scale of $0-$40. He said that the homeless took priority over anyone with a house to stay in, but that they could probably look at me today.

So we went in.

I was expecting everything I'd been warned about with sliding scale clinics--general dinginess and crankiness, and that you wait all day in the hopes they will fit you in before they close.

But the experience was incredible.

The waiting room was clean and cheerful; and the form I filled out was something else! I've never seen anything so ....politically sensitive... in my life. It wanted to know what gender I was born with, and what gender I identified with now, and what pronoun I preferred to be referred to as [he/she/ze/other__________]. I had no idea that a bureaucratic form could be so cautious and respectful. It also wanted to know where I was living, or had lived, in the past year: couch hopping with friends, in shelters, on the street--it had about 10 or 15 options, the last one being: "owning or renting a residence".

I didn't have to wait long. The orderly who took my blood pressure was friendly, and made eye contact and real conversation. When I asked why blood pressure has two numbers, he explained the difference between systolic and diastolic pressures. Systolic is the higher number, the first beat of the heart, pumping blood through your whole body. The second, quieter beat [you know how the heart goes 'BA-bum, BA-bum'], just pumps blood through the respiratory system where it can pick up oxygen. Who knew, hey? He was friendly and joked with me, and he sympathized, talking about similar symptoms he had experienced.

The doctor, too, was really fabulous. She made eye contact, she listened carefully. She gave me as much time as I needed to ask questions and answered them thoroughly. She also check in with me on other issues, making sure I was not in an abusive relationship, not depressed, that I had protection against STDs--and when I said I was married, she sincerely apologized for not having seen that on the form! She told me that I could come in for my yearly gynological checkup at their office, and that there was reduced-fee drop-in counseling on Mondays if I needed it. She questioned me about whether I was experiencing depression.

In short, it was a medical experience where they treated me as a whole person and not like a hypochondriac who exaggerates half her symptoms and should be whisked through as quickly as possible.

They gave me a 10 day antibiotic that worked wonders.

And incredibly, they didn't charge me a thing. (I made a donation anyway.)



~I should note that I have been writing installments on this entry since the middle of February. I started it while I was still sick, and finished it today! Hopefully this will shed light on any time discrepancies.~