Mental Health Update

Today is World Mental Health Day!  So I figured . . . what better day to finally come back to my blog and post an update about my mental health journey?

Overall, right now, my mental health is in a really good place.  In the time since I moved to Washington, I've gotten a psychiatrist, been diagnosed with OCD, and started on a new antidepressant.

The thing is, my mental health had been dipping quite a bit before I left AZ.  For probably the last year that I was in Flagstaff, I started developing OCD symptoms.  Now, I struggled with OCD as a child, and there's always been a small element of it with my issues, but it had never been a huge problem for me as an adult.  When Jenny and I got to WA, the OCD peaked--I'm sure the stress of the move and the transition into working from home contributed.  It got to a point where it was impacting my life: showering was a massive undertaking that took hours, I couldn't leave the house without doing multiple OCD routines, I wasn't sleeping . . . it was a nightmare.  I started seeing my psychiatrist in the summer of 2017, and at that point, the plan was just to get me re-medicated and see if that helped.  I had hopes that it would, because the OCD had been getting worse as my medication issues had gone on (remember, I didn't have a regular psychiatrist and regular prescriptions for the last year or so I was in Flagstaff).

For all of 2018 I did well with my meds, but the OCD just got worse.  So in January of 2019, I told my psychiatrist I needed something different, because I just couldn't do it anymore.  I had done a lot of research and I asked to be put on Zoloft.  Thankfully my doctor was totally on board, and he thought Zoloft was a great option for me.  So we started that, and I titrated up to a 200 mg/day dose, and . . . it has actually helped a TON!  I've eliminated or limited a bunch of routines, and even with the stuff I'm still working on, my life isn't nearly as impacted by it.  I feel SO MUCH BETTER than I used to, so much more capable of just living my life.  It's great.  And hopefully it keeps getting better, because there are definitely still some things I'm working on.

Another thing that's been really good the past year-ish has been that I've been able to really think about my issues and kind of delve into them and figure myself out.  For example, I've recognized a very specific anxiety trigger that has been with me since I was a kid, I was just never able to quantify it before.  And I recognize that my OCD gets worse in certain situations, like when I'm PMS-ing.  

My overreaction/rage issues are pretty much completely gone.  That's probably the biggest change I've noticed about myself is that I'm just calm about things that, if they happened years ago, would have made me break down.  Last fall, for example, Jenny and I went to leave the apartment to run errands one day, and the car wouldn't start.  I couldn't get it towed for a couple days, and then it took a few days to fix, and . . . it just didn't bother me.  I mean, I wasn't thrilled, because it was a very expensive annoyance, but I took the bus when I needed to go out (I was still working at home when this happened) and just . . . handled it.  As frustrating as it was, it was good to see that progress.  I'm just a lot more capable of dealing with life than I used to be.

I also have a much stronger sense of self than I used to.  That was something I struggled with for a long, long time--feeling like I didn't know myself and had no clue who I was.  And I remember stressing about weird things like not having a cohesive set of hobbies and stuff like that.  But now I'm in a place where I can just embrace and be happy with whatever I feel like doing because . . . it's all me.  (I know that's cheesy as hell but it's true!)  Some days I write, some days I sew, some days I hike, some days I play Overwatch . . . and it's all awesome and I love it.  I actually LIKE myself now and holy crap, it's a good feeling.

And of course, Jenny has been a fantastic help and support through all of this.  I truly don't know what I'd do without her.  (For the record, we're still just roommates/best friends/exes . . . and it's still easy and not weird or awkward or anything.)  

I really am happier and more content than I've ever been as an adult, and I have so much hope and optimism for the future!  I think things will only get better from here.

New Chapters

After I got laid off at MHC, I took some time to just . . . do nothing.  My severance package and PTO cash out was pretty generous, so I wasn't in a super big hurry to find something new.  I decompressed and got some cleaning and organizing done around the house, I went to the gym, I played Overwatch.  And then I filed for unemployment in AZ, which was denied because my wages were reported in WA (that was a whole dumb thing), and that got approved.  And then I edited my resume (after not touching it in like 7 years) and added MHC to it.  And then, finally, I decided it was time to start looking for a new job.  (I honestly don't know why/how I was so calm about it, but I really was . . . My gut feeling was that it wouldn't take me too long to find something).

Anyway, I've been active in AAPC since I moved up here (I'm actually chapter secretary at the moment, for the second year in a row), and one of the things we ask is for members to let the group know about job openings.  And as I was getting ready to start my job search, I remembered that another AAPC member had been announcing a coding job for quite awhile, working in the physician's practice area of a local hospital.  It's really weird because the very first time she announced it, I thought it sounded really interesting, and for a minute I wondered if it was time for a change.  But I decided against it.

Well, the job was still available, and I found it on Indeed and applied.  I figured since it had been open so long I had a good chance, even if I wasn't quite as experienced as they wanted.  Within like . . . 2 days of applying, they asked for a phone interview, which I did.  And then I had to do an in person interview, which took forever to schedule (it's a long story, basically the dept. currently has an interim director who is based in Virginia, at corporate headquarters, and she is only in Olympia like once a month for a few days).  My phone interview was January 13th, and my in person interview was on January 21st.  The in person interview went SO well.  I just had so much confidence going in.  I truly don't know where it came from, because I was pretty anxious like . . . until I walked into the building.  And then, I don't know what happened, but . . . it was awesome.  The interview ended up lasting a little over an hour, and when I left, I just felt like . . . yeah, this one's mine.  Very much like how I felt after my MHC interview. 

I officially got an offer on January 29th/30th, and on February 4th I went in and did new hire paperwork/drug testing/background check stuff.  I didn't get to start until February 17th, because the hospital only has new hires start every 2 weeks, and every new hire has to do a whole day group orientation.  There were only 2 other people in my group so that was kind of cool.

So far it's gone really well.  After the first day in my department, I was just pumped.  I like my job (some A/R, some coding, eventually a lot of auditing/provider education), I love my boss, and my office mate is my AAPC friend who actually announced the job!  I'm currently working from home again because of the pandemic and it hasn't been bad, but I do miss the office.  The system and processes are very different than at MHC and it's been an adjustment for sure, but in a good way.

AND while I was looking at job listings online, I came across one for a sleep clinic called ISC.  Jenny had applied there before because a couple of her coworkers had left ORS for ISC because they pay and benefits were better.  She never got a call back the first time.  But as all this was going on, things were getting bad at ORS.  Like Jenny was basically doing the work of 3 people and hadn't gotten a raise since just after she started, and she was still making minimum wage.  The owner of ORS just "doesn't do" cost of living raises--he only believes in merit raises.  And she was already doing 3 jobs so . . . what else could she possibly do to go above and beyond?  The ISC ad posted when I was looking for work said they were urgently hiring, so I let Jenny know.  They called her back really quickly, and she got the job!  She actually started at ISC on February 11th.  She's SO much happier there and so glad to be done with ORS.  Even moreso considering that if she was still at ORS, she'd be the only biller because 2 people have quit, AND the supervisor is on indefinite medical leave.

So we both got new jobs, and we both got raises (Jenny got $3/hour, I got $5/hour).  I definitely feel like I was ready for a change, and as much as I loved MHC, maybe getting laid off was a good thing.  I feel like I'm finally in a truly adult job, and I like working somewhere local.  And with our new combined income . . . I don't really want to say much and jinx it but let's just say homeowner-ship is no longer completely out of the question for us.  I mean, it's still going to be awhile, because my hours got cut because of the pandemic, and I have some new fun medical debt, but STILL.  Once things get back to normal . . . fingers crossed!

Goodbye MHC

Remember how I said a few posts back I was still working for MHC and loving it?

Yeah, that's no longer the case.

This story actually starts in 2019.  I found out that one of our doctors was retiring, and that another was leaving at the end of the year.  Didn't seem like a big deal.  But then I found out another doctor was leaving, and then a month or so later, another one.  It was super weird.  And then we got a company wide email that mentioned something about "if patients want to follow Dr. A or Dr. B to the hospital blah blah blah."  And that was super super weird because in 2016, the hospital had closed its outpatient cardiac clinic, partnered with MHC to take over that service line, and we'd taken on most of their doctors and patients.  I mean, that's literally the whole reason I got to keep my job at MHC when I moved.  That email also said that no one was being laid off, but that no one who quit was being replaced.  So . . . bad signs all around.  I started to worry a little about my job security.

But we still had a handful of doctors, plus our mids and techs, and I had faith.

And then, in November, the last doctor standing AND his mid decided to go to the hospital as well.  This meant that, essentially, by March of 2020, we'd have only one cardiologist, a sleep doctor, and a handful of mids as far as providers go.  At that point I alternated a lot between being absolutely convinced I'd be losing my job around my birthday, and being sure that since I was a very senior member of billing, plus a remote (and lower cost) employee, I'd be fine and manage to stay on through the craziness.

I was actually wrong on both counts!  On December 30th (a Monday, my first day back after Christmas vacation), I got a call from my boss, letting me know that massive cuts were being made and I was being laid off.  I was LITERALLY the first person to be let go.  Which felt just great.  The entire department except for the manager and the other coder got fired.  So did most of auth., and I'm assuming a good chunk of records/front desk types.  It was a terrible, terrible way to end the year.  I can't really say it was out of nowhere, but based on when each provider was leaving and how much outstanding stuff they had out there, I really didn't think it would happen that fast.  But it was . . . abrupt.  I think it's because I wasn't in the office.  I didn't get to say goodbye to anyone, or like . . . have any kind of option of coming back if I had to.  It was pretty much you're fired, log off, and my access was terminated by the following morning.  Just like that, after 7 years . . . over.  It was surreal.  I just felt very lost.  Not just because I had to find another job after so long, but because I knew I was going to have to transition back into working outside of the house.  That was daunting.  (It worked out, though, and I got a new job pretty quick, and I like it, and Jerbs also got a new job in the process, but more on that later).

Really the big takeaway from the story is this: the hospital absolutely, 100% fucked MHC over.  Apparently what the hospital meant when they said they wanted to contract with us for 10 years, what they actually meant was that they wanted to watch how MHC ran things for 3.5 years to learn how to do it correctly, then steal their doctors back, reopen their clinic, and tell MHC to fuck off.  They had to pay a LOT of money to do it, between the penalties in our contract and buying out some of the doctors' contracts.  It's fucking garbage.  On top of that, MHC's medical director and founder (who literally started MHC because he saw how awful the hospital was with outpatient cardiology and was sick of it) opted to retire instead of going to work for the hospital.  Really, that was the best option for him, but it sucks for the community to lose such a great cardiologist.

As of April 17th, MHC as a clinic closed and was bought by the hospital, so essentially they fucked us and then bought our building so that the can expand into it.  The official story is that our medical director approached them about a sale because he was ready to retire . . . which is total bullshit.

As sad as I am about MHC closing and losing my job and everything, I'm more pissed about what the hospital did to us.  It's just so epically shitty.  And this was probably the hospital's end goal the whole effing time, and that's really infuriating too.  It's sad because MHC's founder's goal was to eventually take over the outpatient line for the hospital, and it was such a huge deal that he finally accomplished it.  And it ended in bullshit.  (Although, interestingly, I heard through rumors as all this was going down, that over the years after MHC opened, it was the first CEO who was reluctant to make a deal with the hospital.  The whole deal picked up steam after he left a few years back.  So I kind of wonder if he had a feeling that something like this would happen.  It doesn't really matter, but I am curious).

So that's that.  I'm still sad.  But like I said, I have a new job, in Olympia, and I really like it, and I'm making like $5/hour more than I was at MHC, and I think being out of the house is good for me right now.  Well, not RIGHT now, because I'm currently working from home again because of the Covid19 pandemic.  I'm extremely grateful for MHC because it really came along RIGHT when I needed it, and it led to so many good things.  It increased my confidence, taught me a LOT of valuable skills, led to me getting a professional certification . . . all of those things were necessary to get the job I have now.  Plus I wouldn't have Max if it wasn't for MHC, because I got him from a co-worker, and I love that little sausage dog more than I can say. 

It really feels like the end of an era, the end of something really big and important and meaningful, and that sucks.  But at the same time, I am SO happy for this next chapter, whatever it brings!

Nikolai James

I'm still not sure how much of the past few years I'm going to get around to blogging about, but the story of how we got our little buddy, Niko, is too good not to share.

Like I said in my last post, Jerbs' mom unexpectedly passed away last year.  It truly came out of nowhere and I think it goes without saying that it was just a terrible, terrible time.  The combination of the loss and being so far away when it happened (because we were in WA, obviously) was just . . . overwhelmingly bad.  And on top of that, there was a huge delay as far as the funeral/burial, and because that was all so uncertain, we weren't able to plan flights and had to road trip to AZ.  That drive suuuucks.

So anyway, we were in Kingman at the end of June.  Jane's whole side of the family (9 brothers and 2 sisters plus their spouses and kids and, in a few cases, grandkids) were in town.  I really only spent time with them on the days of the services for Jane, but Jerbs, of course, was with them non stop.  The week we were there, Austin was playing in a baseball tournament; he had a game on Thursday night, a few days after we arrived, and by then, Jerbs needed a break from her fam, so she came with my family and me to Austin's game.

Now, my brother in law was there with my step nephew and step niece; my step niece (Nic) isn't super into actually watching ball games so she was off playing with her friends at the park.  Nothing too new or exciting, but about halfway through the game, she walks up to the bleachers, carrying this tiny little grey kitten, and she pretty much holds it out to her dad and my sister and says, "I found this in a bush!  I stuck my hand in to get it and it didn't bite me!"

The parentals were pretty much like, um, no, you can't have a cat.  But I was sitting a little above them at the top of the bleachers and I could tell that the cat was possibly a Russian blue, so I called Nic over and took him.  Sure enough, it was a little boy Russian blue, mauve paw pads and all.  Jerbs and I were completely in shock.  He fell asleep in Jerbs' lap, and pretty much didn't move for the rest of the game.  We pretty much knew right away that we were going to be taking him home, because . . . well, how could we not?  Thankfully Jerbs' aunt said he could stay at her house until we left, so after the game, we bought him some kitten food and a little litter box and all that, and took him over.  He spent a few days there, and was spoiled/cuddled/loved on by all of Jerbs' aunts and uncles.  We also put ads on Craigslist and Facebook, just in case he was somebody's cat already, but by the day we were leaving, we'd had no responses.

So we brought him home to WA with us.  He loved the car ride home, and loved the dogs right away (and now he thinks he's a dog); he slept on my pillow in the hotel when we stopped for the night.  For the first couple months we had him home he slept in my room, usually on my pillow, until he decided he was too big for that.  He's a very brave cat--we intended to kind of keep him alone in my room for a week or so, because he was tiny and the apartment and other cats are so big.  But . . . Niko had other ideas, and within a day he'd completely slipped past me and explored the house and met Irene and Ilya.

The girl cats have done OK with him.  Irene is mostly disinterested, although she will sometimes lay next to him.  She'll also kick his ass when he tries to jump her, which is usually pretty entertaining.  He and Ilya are friends, though, and they cuddle and he grooms her and she sort of actually plays with him.  Sometimes he's a bit much for her (he plays VERY aggressively sometimes) but mostly it's all good.  And he still loves the dogs, and his fave thing is playing with Hollie.

We struggled naming him.  We considered desert-ish names (Sage, Saguaro, Mesquite, Zona, Tumbleweed) and Peanuts related names (Snoopy, Woodstock, Spike) and Russian names (Ivan, Tolstoy, Leo, Dostoevsky).  Eventually we settled on Nikolai, both because it's Russian and because it's similar to my step niece's name, Niko for short, with a middle name of James to honor Jane.  Niko loves feather toys more than anything, he begs for treats with the dogs every morning, he walks on a leash like a champ, he and Jerbs usually fall asleep together on the couch on Friday nights, and when he was little he liked to be zipped up into my sweatshirts to keep warm.  He is the sweetest, cutest, dumbest little thing and we love him so much.

I firmly, absolutely, 100% believe that Niko was sent to us by Jane to help us through the grief of losing her.  The odds of finding a Russian blue kitten in (essentially) the desert, at the time that both of us happened to be there despite living 1200 miles away, the day after we laid Jane to rest . . . He was a gift from her.  And the fact that he was so calm once he was with us, even though the crowd was cheering and there were other games going on and loud announcements happening--it was like he knew he'd found where he was supposed to be.  Jerbs' aunts and uncles all agreed.  I am so grateful that we got him, because I think he really has helped Jerbs through losing her mom; he's a tiny tangible reminder that her mom is watching over her, and that's beautiful.

And now some pictures of our little pal.

Stealing my office chair.

Cuddling with Jerbs on the drive from AZ to WA.

The first time he got into my window on his own.

All zipped up in my sweater.  This was how I worked for most of his first winter with us.

Growing up handsomely.

He sleeps in the funniest positions.

Hiding under the Christmas tree table so he could jump out
at the dogs.

When he got neutered and had to wear the cone.

He LOVES to shred paper products, so if paper towels,
toilet paper, tissues, etc. get left out . . . they get attacked.