Tiz Spring

I know it’s Spring as I rode home without wearing my jacket and all the college kids were outside, listening to boom boxes, playing with hurling sticks and balls, soccer balls and Gaelic footballs, enjoying a bit o’ beer or wine, sitting on chairs they drug out of their front rooms and cooking on the grill.

T’was lovely.

— Claude

The joys of socialized medicine

“Remember that there is nothing stable in human affairs; therefore avoid undue elation in prosperity, or undue depression in adversity.” — Socrates

There was a strange convergence of good and bad when this opportunity to come to Ireland arose.  Claude had been trying for years to find a position/job/occupation that would afford him the chance to move here.  The blessed event came to pass in September of 2011 when he was offered his current position as third-party researcher at the National University of Ireland Galway.  At the same time as this was occurring, I had, for lack of a better description, an attack – which eventually led to the MS diagnosis.  I even cracked wise to him about how his fantastic news had to be tempered by a drastic diagnosis for me because that’s the way the universe works.

At the time we were covered by the health insurance offered by his employment in Colorado.  Due to the fact that my primary care physician (a fancified term for family doctor) didn’t really know what to look for, and the subsequent fact that she referred me to an incompetent boob of a neurologist, it took 3 MRIs and a ridiculous number of office visits to finally get the diagnosis.  By the time it finally did happen, I was informed by the incompetent boob that it was too late for the recommended treatment of 3 steroid infusions over 3 days.  He recommended a drug that came from the manufacturer directly, something I had to fill out an application to obtain, then wait for them to process it through my insurance, then wait for them to send out the drugs and a home care nurse to show me how to shoot myself up with it.  All of this was occurring while we were preparing ourselves for an overseas move.

I finally had to call the drug company about four times before I got the meds, then took them to my PCP’s office to have her nurse show me how to stick myself because the home care person was not calling me and time was running.  I also discovered that the health insurance would only pay for 4 doses, never mind the fact that I was going to be moving overseas and it was going to take me God-knows-how-long to get another physician to prescribe more meds.  I wasted time and money and health taking those four doses of medication, which made me sicker than I already was.  The “nurse” at the drug company sympathized with my plight but could do nothing useful or helpful.  Ah well, I thought, I’ll just go without until I can get into the health care system in Ireland and get my medical card.

By this time we were in Ireland, scrambling to find a place to live while Claude was starting an entirely new job.  There were Garda registration cards to obtain, and a bank account to open, and there was a raft of paperwork to do for the university.  I contacted the Irish MS Society and spoke to a very friendly and informative man who gave me much of the information I needed to get started with the system.

And then everything stalled.  The woman at the Health Services Executive (HSE) told me to do the paper application rather than the online app because I had to write a personal letter explaining my situation.  That was my first mistake.  I was told I had to provide proof of residency in the form of a lease and utility bills in my name.  We got that process started but it took several weeks to get all that from the cable & electric companies.  We tried to open a joint bank account but they wanted so much paperwork and so much information and it was taking so much time away from Claude’s work hours that we decided to forgo that part.  I was told I was to find a general physician who would confirm my diagnosis and refer me to a neurologist – I got lucky enough to find a local doc who worked with MS patients and took care of me and my needs at no charge.  He referred me to a neuro guy at the public hospital.  It took two months to see him…

I provided the HSE with the hosting agreement showing the one year commitment to Claude for his job, the one year lease on our home, the Garda reg cards showing the one year length, utility bills in my name, a copy of Claude’s paystub (only one at the time as he had only been on the job for one month) the application with the GP’s information and signature, and my letter begging for a medical card.  I was told that I had not provided enough documentation.  They needed his tax form from the university and more paystubs.  Then they wanted bank statements.  Then it was my American medical records.  Now they’re saying we don’t have enough debt and continue to disregard the fact that I have a long-term illness and as such am entitled to the medical card.

In the meantime I have seen the neurologist, who seemed a bit skeptical about me and my story, or maybe he was just inscrutable and I read him all wrong.  I just got

Merlin Park Hospital

the feeling that he really didn’t believe my diagnosis.  Maybe it’s because MS is a young person’s disease and I am no longer the proverbial spring chicken.  The incompetent boob did show me the proof of my diagnosis on the MRI scans and told me it was conclusive proof, so either he really was that fucking incompetent (excuse my language) or he was right.  The Irish neuro wants to do the 3-day, 3 treatment steroid infusion that the incompetent boob said I didn’t need, as well as a new MRI for his baseline.  But unlike the States this treatment has to be done in hospital here.  The good news, if one can call it that, is that under the public health scheme the hospital only costs €75 per day.  We’re not entirely sure if this includes food.  However the MS nurse I saw right after the neuro doc assures me that I will also receive physical therapy treatment and other therapies related to MS.  But I have to wait for them to tell me when I am entering the hospital and I have to call the day before admission to make sure there’s still a bed for me.  I’ll let you know if that experiences sucks or not – I mean, more than it usually sucks to be in the hospital.

This morning’s call from the HSE proved once again that the people who work for the entity are kind and caring individuals who have to give bad news to people on an everyday basis.  I was told our income is too high, we don’t have enough expenses, then advised to produce information proving Claude’s child support obligation.  When I asked the woman about getting a card simply by virtue of my long-term illness, she asked me to provide medical records.  Trying mightily not to sigh audibly in her ear, I told her I had done so, by registered mail, over 2 weeks ago.  She checked and saw that they did have that information and advised me to wait at least another 10 days for a determination from “management.”  I have called my GP guy and asked him to provide a letter backing me up for the medical card.

Once again, only time will tell.  But in the interim I am put in mind of the people in America who bellyache about socialized medicine, about what a crap system it is – and I think of my Canadian friends who tout the system and say it beats the hell out of private health care.  Having been a victim of both, I can categorically state that at least the health care I have received in Ireland so far has been infinitely less expensive than the health care I received in the US.  I can’t say that it’s been better or worse on either side, as I have had two really wonderful General Practitioner/Primary Care Physician (s) and two very so-so neurologists.  Maybe I won’t get that medical card.  Maybe it won’t matter because so far the measures I have taken to care for myself seem to be working fairly well.

Through all this I have had the support of the greatest husband any woman ever dreamed of having at her side.  Perhaps that is the best medicine of all.

— Cindy

“You will never truly know yourself or the strength of your relationships until both have been tested by adversity.” — J.K. Rowling

The Bay

Galway Bay is an amazing body of water.  Every morning as I ride to and from work I take the time to appreciate it.

Its coloring changes from minute to minute with the weather.  During wet and windy weather it has a dark brooding feel with foamy crested ridges, though often the sun will strike the water from over in County Clare and provide a silvering of the horizon.  At sunset or sunrise it can transform into a rilled  grenadine red sea.  During the day it is a blue or green and often with the silvering of the sun threatening to blind.

The scent of the salt, seaweed, drift wood, and wet sand permeates the area.  On sunny days the scent of warm rocks and sand whispers to me and induces the lethargy of late spring or early autumn.

On the windiest of days the salt and sand can be felt as well as smelled, and at high tide the breakers wash across the prom leaving ridges of deposited sand to dry in the next day’s sun.

On some days the Clare coast is as clear as a bell, the sea spans the horizon to the west, and on others it is shrouded in mist and fog.

The bay, it is always there, it is always the same and yet it is always different.

— Claude

On Being Irish

St Paddy’s Day is passed and I have come to reflect on the quiddity of the Irish people.  An Irish friend told me that the Irish have a fundamental philosophy that dictates that things will work out.  His example was that one of the non-Irish directors at work became concerned about a change in political will at the highest levels.  To hear my friend tell it this director was running around like Chicken Little for want of a new strategy and plan.  His Irish counterparts were much more relaxed and and took the serene Irish approach to the problem — Things will work out: cibé rud a tharlóidh,  in Spanish que sera sera.

The Irish don’t appear to have the rugged individual as an archetype; there is no Marlboro Man.  While there is a concept of ownership and a pride therein, there is also a concern for others.  There seems to be very little of the “I’ll take what there is and others be damned” attitude that I find so prevalent in the United States.  There seems to be more concern about the smaller guy, perhaps because in international dealings Ireland is the small guy.  When the Irish economic bubble burst a few years ago, Ireland, under the pressure from the International Monetary Fund, (IMF) bailed out the Anglo Irish Bank (AIB) and implemented austerity measures that pushed the people farther into poverty and the economy to the brink of insolvency.  The government finds itself squeezed between the corporastocracy-inducing IMF and the anger of its people.  So how does the anger of the riled up Irish express itself?  Currently I see protests (Occupy Galway, household tax protests), and political humor in the St. Patrick’s day parade in the form of St. Patrick chasing the AIB snakes out of Ireland.

What does it mean to be a US Citizen in Ireland?  I feel shame.  From this small country arises an armed force of 13,500 soldiers.  And where are they deployed? From Wikipedia: Army personnel are currently serving in Kosovo (KFOR & UNMIK), Bosnia Herzegovina (EUFOR BiH), Western Sahara (MINURSO), Congo (MONUC), Afghanistan (ISAF), Chad (MINURCAT), Côte d’Ivoire (UNOCI), Lebanon (UNIFIL) Haiti (UNDAC) and the Middle East (UNTSO).  Seems like they are helping people or cleaning up messes made by the US.   In the St. Patrick’s day parade, there were members of state police from Massachusetts.  Their uniforms, in stark contrast to those of the Irish Garda, were very militaristic and fascist in appearance.  While they may be the good guys, out to protect and serve, they didn’t portray that.  They portrayed the “might makes right” philosophy of the US Government.  Another float in the parade portrayed the Irish government ministers under the control of the banks and the banks making millions on the arms trade.  I feel shame that the US is the worlds largest arms trading country.  I feel shame that the US government has become a corporastocracy.  I feel shame that Abraham Lincoln’s Gettysburg Address has come to ring hollow.  The US is now engaged in several foreign wars proving that government of the corporation, by the corporation, and for the corporation can long endure.  I feel shame that I lived in and was part of the worlds largest bully.

I feel wonder and awe at the Irish.  Socialism is alive and well here, and unlike the specter portrayed in the US  by the far right bleatings and machinations it is not a bad thing.  The Irish are approaching a crossroads.  They will soon decide if they will continue down the path of corporastocracy and all it entails or take another path.  I hope their quiddity leads to a government of the people, for the people and by the people and that it shall long endure.

Corporastocracy : (n) Government under control of corporations.   Often felt to be a kakistocracy.

— Claude

The Town Bike — A Lyric Waxing

As I noted before I have a city bike.  I bought the bicycle when I moved to Denver, CO from the nearby town of Evans.  At the time Cindy and I had decided to move to the city and try to live our lives without the benefit of the automobile.  We were not going to completely quit using our car, just reduce the use to a bare minimum through the use of bicycles and public transportation.   Denver, it turns out, has one of the best public transit systems in the United States, so I spent most of my time on the bus and the bicycle sat in the basement.  I took it out once a week or so to ride to the store for groceries or just because I was going stir crazy and needed to ride.  It was one of three bicycles I had in the stable and probably the one I rode the most.  The road bike (old Trek 720) rolled easier but was more susceptible to punctures.  The Mtn Bike (Trek 3700) took the dirt better but had a much higher rolling resistance.  In any case, I, like most Americans, did not ride as much as I thought I would.  I will admit that on some trips to the grocery I loaded the panniers to their maximum capacity and strapped other items on the top of the rack to the point that the front wheel rose off the ground.

In coming to Ireland that all changed.  First, I left the other two bikes behind as there is not room to store them here.  Second, because while the public transit system in Galway works, it would take me far longer to ride the bus than to cycle.  My experience with the flat tyre leads me to believe that it would take almost as long to walk as to ride the bus to work.  So I ride my bike to work every day.  I normally take a route that is longer but flatter than the direct route, though if the wind is particularly strong I’ll take the hilly route as it is shorter and the hills protect me from the wind until I reach the downhill stage.

The roads in Ireland are small, paved, with a few potholes here and there.  Riding through the University region there seems to be a great quantity of broken glass, but all in all the environment is conducive to cycling.  I recently calculated that in the 4 months that we have been here I have put as many miles on my bike as the average racer put on in the Terreno-Adriatico this year, so perhaps I should review my trusty steed.

There are several things that make this bicycle a great commuter bike:

  • The fully enclosed chain keeps the dirt off my pants or leg and keeps the road grit and rain out of the chain.
  • The suspended seat post makes for a smoother ride.
  • It has an internal gear hub so there is minimal maintenance.
  • It comes with a rack, standard.
  • The middle width road tyres (narrower than a mountain bike, wider than a road bike) have a lower rolling resistance than the mountain bikes I see everywhere in Galway.  While it is not as low as the standard road bike, it also provides more cushion against the occasional pot hole.
  • The lights are just there.  The dynamo in the front wheel means more rolling resistance, but it is much lower than the old spindle against the tyre dynamos of the past.  While I was waiting for my bicycle to show up from the states I borrowed one and purchased a flashing headlamp and tail light.  I have mounted those on the city bike as well.
  • The tires have a reflective stripe.
  • The fenders are included

There are several things I have changed from the original configuration:

There are several things that I find annoying:

  • Patching the rear tyre is a pain in the butt.  The fully enclosed chain guard has three screws that need to be removed before the rear wheel can be taken off the bike.   Keeping in mind that the chain guard is plastic, removing and resetting the screws multiple times will lead to thread wear and potentially the inability to replace this part of the chain guard.  The plastic tabs on the chain guard also have to fit together just right to put the guard back in place.  Every time I replace the guard I am afraid I am going to break the tabs off.  The other issue here is that you have to have a Phillips-head screw driver.  I would like to see this component reworked, possibly with a wire bale closure a la kitchen canisters.
  • The gear position indicator, on the twist grip, does not always line up.  I mostly notice this in 4th gear where the indicator seems to say 4-1/2 gear.

There are only major two issues that I have had to deal with:

  1. I had a problem with the rear hub where the mechanism that locks the cable guide came loose and the hub ceased to shift.  I noted this in an earlier blog.  I think this was an assembly defect in that the locking ring was probably not correctly installed as it seems to be functioning correctly now.
  2. The other problem was with the shift cable guide on the chain stay.  It was not there.  I am not certain if I broke it off when I tried to remove the rear wheel, or if it was not installed at the factory.  Once I discovered the problem I used a cable zip tie to hold the cable to the clip mount on the chain stay and all seems to be working well.

There is one item that I find useless: The European bike lock.  This is a little pincer-like lock that locks the rear wheel so that it will not roll.  While this may work in places like Amsterdam where there are few cars and carrying the bike would be a pain, in the States and probably here in Ireland, there are enough vehicles to throw the bike into and cart it away to make the lock useless.  To make matters worse, the key for the lock can not be removed without locking the lock.  So you can’t disable the lock and if you forget to lock the lock and remove the key some prankster can prevent you from getting home by doing just that.

All in all, if you want to ride a bicycle for general transportation this one should be on your list of bicycles to check out.

— Claude