MS Strength

I just came back from volunteering at the library and I’ve had a certain book on my mind. I read it during some MS relapses, just to remind myself of what’s really important. I’ve read it again recently because I’m probably jonesing for some good non-fiction and haven’t found any. Nevertheless, here’s one of my favorite books and the reasons why:

The Four Agreements by Don Miguel Ruiz has simple, layman’s techniques for living a joyful, true existence. This Mexican spiritualist explains his Toltec beliefs that transform a life of suffering and sadness into a vehicle for optimism and growth. He uses four simple ideologies to help steer people in the direction of happiness, no matter what their circumstances:

• The first agreement is “be impeccable with your word.” It doesn’t quite mean what it implies. I initially thought it meant “don’t lie or make empty promises”, but it is quite a bit more. Ruiz explains that whatever comes out of our mouths should be honest but also pure in intention. People are guilty of slandering others and passing along useless gossip and negative energy. I know I’ve been guilty of such. Ruiz says the first step to happiness is to remove such verbal weaponry from your life. Then intention can become pure and true.

• The second agreement is “don’t take anything personally.” Sounds simple enough, but there’s more to it. Everyone has his or her own agenda, thoughts, background, personal situation, and so on. What comes out of a person’s mouth is merely a reaction to his or her own situation, and nothing to do with you personally. It might seem that way, but because we all have struggles and personal lives that are not completely apparent to others (usually), we can never take insults or ignorant responses personally.

• The third agreement goes naturally with the second agreement: “don’t make assumptions.” Again, Ruiz mentions, it is impossible to know everything about a situation or a person, so to assume things about others can make you take information or words personally. Then you become caught up in the vicious cycle of slandering and then being slandered. Tough, unproductive cycle. Ruiz suggests taking everything with a grain of salt, because you really only know fully about yourself. The rest of life is made up of other people’s realities.

• The fourth agreement (which is my favorite and probably a great mantra for people with multiple sclerosis): “always do your best.” This is just a matter of taking each day and giving honestly what you can. Today’s best might be venturing aided or unaided down the street. Tomorrow’s best might be intently reading a good book and gaining knowledge. Ruiz emphasizes the importance of achieving the first 3 agreements to leave the mind and body pure to accomplish one’s personal best. And one’s personal best is always enough.

I would add one more personal agreement that I try to follow: “have a sense of humor.” Because it’s gonna take a hell of a sense of humor to stick to the rest of the agreements! Find out more about The Four Agreements…

I just came back from dropping my Medicare parts A and B coverage. I stopped in at my local social security office and opted out. Here’s why:

• My husband has us covered under his small (less than 35 employees) company coverage, and even though it socks us with an almost $800 monthly premium (combined), it doesn’t cover dental or vision expenses, and it has a $30 copay for all medical visits, it DOES cover my Betaseron ($2k/month) in full, so there’s no copay.

• I investigated Medicare’s coverage. Part A covers hospitalization, and it is similar in coverage to Bill’s company plan (and free with part B), but I have some issues with Part B, Medicare’s medical coverage. There is approximately a $97 premium each month (fine) and a $135 yearly deductible (again, fine.) But after the deductible, Medicare recipients pay 20% copayments on many medical costs. Even on Xrays/ MRIs. So routine MRIs, something that multiple sclerosis patients see as the norm, could end up costing about $4k a year or more, with a patient copayment of $800. Bill’s small company insurance copayment: $30/ per visit x 2 visits = $60. Just the crazy cost for MRIs put up a red flag for me.

• Next, I learned about Medicare Part D, which I am not automatically enrolled in and must elect. My father warned me about this prescription plan. He and my mom, who made modest livings as public school teachers, really lucked out in their retirement. They both have solid pensions and my father’s good health coverage (paid for by 25+ years of work as a guidance counselor.) So they have Medicare and also their own good coverage for prescriptions. Part D is a good plan if the recipient is in general good health and doesn’t have many expensive presciptions. Ironically, this is the coverage for seniors, who tend to acquire more and more health problems as they age, causing them to need more and more expensive prescriptions.

• For a lot of people with MS, good drug coverage is very essential. But when I asked for the best cost for my Betaseron (there are various drug plans under Part D), the best the Medicare rep could come up with was a $250 yearly deductible (fine) and a monthly copay of about $514 until I reached about $4k (after 8 months), and then the copay would go down to approximately $180/month. In the beginning of the year, the whole deductible and higher monthly copay would start again. UGH. Medicare Rx coverage: at least $514/month for most of the year v. Bill’s plan of a flat rate of about $390/month per person for prescription, medical, and hospitalization. And don’t forget the monthly Part B premium of $97. The choice seemed clear. I picked the lesser of the 2 evils.

Here is the part that makes me a little nervous about my decision: I will be getting the monthly Medicare premium back in my social security check, but because I opted out, if my husband somehow loses his job and we don’t have immediate coverage, to get back into Medicare coverage it will cost me another 10% on top of the Medicare $97 monthly premium for every year after I dropped the coverage. So if I find myself needing Medicare in, say, 14 years, I will then pay a monthly premium of about $240+/month for pretty mediocre to bad coverage. That’s not even counting the yearly increase in the original monthly premium. Or the $514+ monthly copays for the Betaseron!

If my husband worked for a larger company (100 employees or more), then I would incur no penalty for dropping and then reinstating Medicare at a later date. Fortunately I can reinstate it when I’m 65 with no penalty. Hopefully something better will come along in the meantime.

Congratulations, Ellen—- you rock!!!!!