Let’s (really) talk about healthcare

My health care story goes like this: It’s often difficult to find and maintain a good doctor. I have had four good doctors in my adult life; three of whom were gynecologists. The fourth doctor was my primary care physician. All of them were women, and they “got” me. I felt comfortable talking to them. I knew that I could be candid. I felt that each doctor had my best interest at heart. She listened to what I had to say; in some cases heard what I tried to sweep under the proverbial rug. I always felt that any recommendations were medically sound with my best interest at the forefront that advice.

I had to switch two of the above mentioned gynecologists because I relocated. My awesome primary care physician relocated. And my now former gynecologist switched practices-(I’ve posted her picture on lamp posts throughout the city), please call me if you find her.

Bedside manner is critically important to me. I have to feel safe, heard, seen, and respected by my doctor. Period. I think most if not all of you would agree with me.

In light of the numerous changes to our health care system, it seems that health care has become “corporate.” With the exorbitant costs of malpractice insurance, many physicians have opted to leave private practice, to join medical groups, or hospitals. Which usually translates to a more structured approach to doctor’s visits, e.g., timed one-on-one sessions with your doctor. In some cases, patients spend more time in the waiting room to see the doctor, than they do with the doctor.

Most private businesses provide their employees with consumer-driven health care plans. Which is customarily defined as an insurance plan that allows its members to use a HSA (health spending account), to pay for qualifying healthcare costs. There are many other key components to these plans that take time to learn and understand, in order to use healthcare effectively and economically. Some people are able to delve into this information easily, while others use their healthcare insurance more passively. For many employer-provided healthcare plans, it’s also the responsibility of the consumer (you/me), to do our due diligence in advance when selecting our health care providers. For example, knowing whether a particular doctor or practice is in or out of network, versus asking the general question of whether a doctor or facility “takes my insurance,” is key.

Health care is a personal necessity that is increasingly requiring a higher degree of business acumen or savvy on behalf of the consumer. Some of us have a better understanding of our healthcare benefits than others. It is also easier to execute when can plan when and how you will you use your healthcare. It’s even more helpful if you can consult with your primary care physician, on what’s the best option(s) for your case. In emergency situations, however, and namely during unprecedented times such as this current pandemic, health insurance coverage, co-insurance, and deductibles becomes a secondary, or tertiary concern.

So when we as a society enter into discussions on why certain demographics are seemingly more at risk, or disproportionately seem to suffer from pre-existing health issues (e.g. diabetes, obesity, hypertension, asthma, etc.), it is imperative that we pan out to see the big picture. A community is only as healthy as the viable options that are offered to, and serve that particular community. This includes proper food and nutrition sourcing, access to safe, clean recreational facilities (e.g. parks, fitness centers), in addition to the availability of local resources, information, and most importantly, quality healthcare facilities, and providers that serve and respect these communities.


Ask RymarkableSteph-A Dream Deferred

Dear RymarkableSteph

So literally I’ve been having a midlife crisis for the last 3-4 years and I don’t know how to break this spiral. I had such a vision for myself, but once I turned 40, that vision seems to be more and more out of reach. I put up the biggest front on my social media platforms, when secretly I’m lying. I’m jealous, very jealous of my friends who have lives that I wanted for myself. I front like I’m happy for them but deep down I’m self-loathing and feeling sorry for myself. I know this is my on doing. I’ve made a lot of poor decisions that have brought me here.
I also know that I can change it. I wake up some days super motivated to make the changes and I start stuff then I lose momentum and get back in a rut. I’m at the biggest weight I’ve ever been. I don’t run anymore or workout like I use to. I haven’t read a book to completion in years and I would do that all the time, since I was a little girl, all the time. Now I just watch tv. Yeah, I know turn it off but it’s easy and it numbs me out so…
I’m sad most days. This quarantine is magnifying my pain. Yep, I’ve been to counseling, numerous times, they help in the moment but then I go home and in a couple of days I’m back. Also, it’s expensive and because of my poor decisions and lack of discipline, I don’t make as much money as should. I have no retirement, no savings, I live in a neighborhood I hate. I own my home and I am thankful but I have wanted to move for almost 10 years and I can’t or I’m scared because it won’t be easy. I like my job again, finally, but it pays shit. People keep telling me I should quit, but I like it there and it’s been a long time since I didn’t dread getting up in the morning to go to work.
I feel soooo stuck. Like is this it? I really don’t know what to do. I cry a lot when I’m alone, people just want you to show a brave face. I have people who try to hold me accountable to getting stuff done but I dismiss them most times or just ignore them until I think they’ll let it go.
Wondering if I’m too old, and too broke to get the life I want. I’m 47, I’ll be 48 in a month. Hell, at this point I just hope to retire with some dignity because I don’t have any kids so no one will take care of me.

Feeling kinda hopeless. Real hopeless.

Dear Dream Deferred,

You are so incredibly brave, honest, and self-aware! I chose your letter because I believe that many people can relate to most, if not all of your pain points.  I definitely can.  Many of us get into the mental gymnastics of age, or what it means to be a certain age.  For me, the iconic Tina Turner is an inspirational example of someone who broke unbelievable barriers, and made an epic career “comeback” when she was over the age of 40.  Maybe you’re not aspiring to become the next Queen of Rock ’n’ Roll, but there is something that you want to do as passionately as Tina wanted to reclaim her name, her talent, and literally, her voice.  

You are transparent about seeking help through counseling; having accountability support, yet you “dismiss them most times or just ignore them until I think they’ll let go.”  I so applaud you for being bold and clear enough to recognize that you’re literally standing in your own way.  I also give you so much credit for honestly explaining how you actively resist participating in your own progress. Though this is likely not your intent. You mentioned that you have gained weight; that you don’t work out as often, that you used to enjoy reading (and finishing) books, but opt to watch television instead.  

Dreamer, it seems as if you have placed yourself in a self-imposed adult time out. You’re not accepting accountability in certain areas, you’re not working out, or engaging in other activities that are more productive for you because it seems as though you simply don’t feel like it. You literally don’t feel like “you.” You don’t feel like finishing the book because maybe it takes too much effort, or maybe it’s not what you need to read right now. Could your lack of interest in activities that you normally enjoy be the result of a recent setback? This seeming apathy could be leftover residue resulting from an unfavorable outcome of something you really wanted or needed. If either assumption is true, it is okay to need a minute to regroup. It is extremely difficult to get back up and dust our knees off after suffering a major “fall” or disappointment. In response, it is absolutely okay to surrender to a period of mourning. In my opinion, mourning is simply the meaningful acknowledgment of the end of something cherished. That said, it is perfectly normal or even healthy, to mourn the end of a relationship, a friendship, a job or career, or anything that had sentimental value to you, and now no longer exists. During this period of adjustment, it is acceptable to pause. But you cannot stop and build a monument in homage to any pain or disappointment you may have encountered. Eventually, you are going to have to try again…if not the same thing, something else.

So, let’s unpack this perception of a “dream deferred” with several questions beginning with the vision you have (or had) for yourself.  Let’s get specific as in, what is your dream?  What do you want to do and what, if anything is stopping you? If there is something stopping you, is it a proverbial stop sign or red light? Who will you serve by acting on this dream, and how will they benefit from it? Are you an entrepreneur, are you freelancing, or a consultant? Are you working in the same city or state that you currently live in now? What about turning 40 made you feel that your dream was out of reach?  Are you aspiring to enter a profession or career that has defined age limits, such as the military, professional athlete, law enforcement? Most careers do not have actual age limitations (at least not legally.) 

Up until this point, you have been acquiring valuable knowledge, credentials, transferable skills, and confidence to help you launch what you’re supposed to do now. This could be the reason why it seems that your growth has been slow, or even at times feeling as though it were suspended. It could also be that you needed to temporarily defer your goals, in order to gain the necessary understanding and information, to equip you to do what you want to do today.

During my journey, I have “tried on”-meaning I have pursued many (and somewhat unrelated) career endeavors, all while having a primary and sometimes, a full-time job. I was a freelance, and part-time make-up artist, I worked in retail, I attended writer’s workshops afterwork; I have taken weekend personal development certification courses. Why? Because, I was interested in those opportunities at one time. In each experience, I learned something priceless about me. I became clear(er) about what I wanted my career to look like, and what I did not want, or could not tolerate. When you embark on a new journey or career path, sometimes you have no clue what the next steps are, or should be. Those who are willing to take chances and remain consistent, are often rewarded in the end (in the form of a career path that is best suited for them.) To claim your reward, you might be required to suppress your ego. We all have an ego, though some are more domineering than others. The ego can be boisterously bougie, all but forbidding you to take unconventional risks. The ego does not want us to waste our time, or rather its time.

I firmly believe that as long as you have breath in your lungs, it is never too late to live a life that you can be proud of. Your age cannot hold you back, however, living in the past, and stale thinking patterns definitely will. You mentioned that though you are working, you are underpaid. I can tell you for a fact that compensation is more than money. You wrote that you enjoy your current job and “it’s been a long time since I didn’t dread getting up in the morning to go to work.” Having a job that you actually like with zero dread, and no Sunday evening blues is the definition of a winning scenario. I agree with you that your job seems like a good match for you in the sense that it’s a major aspect of your life that seems to be working. When we have more aspects of our lives that are working it allows new ideas to flow effortlessly. It can be difficult to take our dreams seriously, when the mortgage or rent is due or worst, past due.

And speaking of mortgage, you suggested that you lack discipline, and have no retirement, and no savings. You also wrote that you are a home owner. The last time I checked, it takes a substantial amount of discipline to go through the homebuying/mortgage process, let alone own your property for I what presume is 10 years. Without knowing anything specific about your financials, or the value of your home versus what you owe, in the general sense, real estate is considered an asset. So, though you may not have a traditional savings, or money saved for retirement, you own real estate with potential equity in the property. You said that you hate your neighborhood. The physical property is “stuck” in that neighborhood…you are not. As a homeowner, you have options such as whether it is a viable option to rent the property to tenants, to sell it, or keep it as a part of your financial portfolio, as you build home equity. Only you know what is best for you and situation concerning your property.

As humans, we don’t want to just try to do something, we demand a guaranteed and favorable outcome.  If the final results are not as we hoped or expected, we often think to ourselves, “Do I continue on this path considering how far I have come and see the final outcome through?” Or, do we say, “You mean to tell me that I have come all of this way and there is no payoff, yet? I’m done!”  And nothing makes us feel more inadequate than what I call, “looking on somewhat else’s paper.”

Which brings me to your point about social media. Again, I commend you for being honest about your feelings of jealousy and self-loathing as it relates to social media feeds. I firmly believe we cannot heal what we don’t acknowledge. When you say that you’re essentially living a double life on social media versus real life, I say that you’re in good company. The majority of us are doing the same thing by carefully curating (read: filtering and altering) our images, narratives, and stories into visually appealing highlight or sizzle reels. That’s all it is and everyone has done some variation of “staging” a photo, or their present circumstances so as to appear more fabulous and acceptable to friends, associates, frenemies, and strangers. That said, what you’re jealous of may be an illusion, or only partially authentic.

It’s about embracing your choices and doing what serves your highest good. It’s also about being your authentic and amazing self. There are numerous ways to show up on social media in an honest way, which also includes not showing up at all if necessary. If you’re having a bad hair day, you don’t need to be “candid” in that moment, and post a phony selfie. Maybe you can post something else like a quote, a poem, a picture, or something else that you’re musing about at the moment.

Now more than ever, the world is a ginormous captive audience desperately seeking relatable, feel-good content. You can potentially fulfill that need. You mentioned that you have books that you have started but haven’t finished; maybe you can post the book cover and ask your followers if they’ve read the book, and if so, what did they enjoyed about it (without giving the plot away.) Maybe you can start a virtual book club, which may invigorate you to finish the book.

Complacency is often the accomplice of fear. You can do hard things, Dreamer. By now you have already mastered hard tasks and navigated through those challenging situations triumphantly. You can do it again, if you choose to. I hope you choose to. One day, you will retire with dignity, because you have chosen to start living a more distinguished life (by your own definition, and on your own terms right now.) No more frontin’ online and faking it in real life. It’s time to impress yourself. Any fear around growing older with the possibility of being alone does not have to materialize for you. By taking exceptional care of yourself today, you will eventually prove to yourself (and everyone else), that you have what it takes to take up space and do more than exist in this world. It’s time to live and thrive, dear Dreamer!

If you would like to submit a question for me to answer via an upcoming Ask RymarkableSteph post, please email me at: RymarkableSteph@gmail.com.

Disclaimer: By submitting a question, you agree that if selected, your question will be posted on the blog anonymously, and may be edited for clarity. All information and resources found on the RymarkableSteph blog is the opinion of the author, unless otherwise stated. Any advice given is based on the author’s own knowledge or experiences, and is not intended to treat, prevent, or diagnose, any medical, or mental health concern. I am not a lawyer, physician, or health care professional. Please always consult with a qualified expert.

Ask RymarkableSteph-Screaming Silently

Dear RymarkableSteph,

I’m a mom with a young kid who hasn’t been well for over a month. It’s nothing serious, thank goodness, but it’s painful at various points in the day, causing us ALL to lose sleep (yaawwwwwn) and of course I hate that I can’t do anything to make it better. I want to be there for my kid, and I have discovered stores of patience I never thought I had, but I have a super clingy and needy kid on my hands who I am the primary parent for, 24-7. I have a spouse, but work is insane, so I don’t have much help in that regard right now. With schools being out and even schoolwork requiring my supervision, I don’t have time for me. Because I need to sleep with my kid these days, because of the illness, it’s not like I can do stuff after the lights are out. I want to be productive in my work life, but I have to squeeze in things where I can (hello electronic babysitter, you old friend) and I have zero time to expand and grow, just when I was building momentum. On one hand I feel guilty for wanting the time to myself (though rationally I know I shouldn’t) and on the other I’m screaming silently inside because I NEED A BREAK!

Do you have any advice for me? Or just a commiserating word to help me deal with my difficult situation right now? (Oh, and the illness is not going to go away anytime soon.)

Thanks in advance,

Dark Circle Dolly

Dear Dark Circle Dolly,

First and foremost, I am so happy to hear that your little one’s illness is nothing serious. I feel for you because it seems all you can offer your child (in this regard), is pain management versus alleviating all semblance of pain and discomfort. The latter of which I am sure you and every mom would gladly do without giving it a second thought. It’s difficult to watch anyone we love suffer. The stakes are even higher, and the heart hurts more intensely when it’s a child who is suffering in any capacity.

Without knowing the full details of your little one’s health challenge, I think you have a lot more options than you are aware of.  The “secret sauce” of child-care providers and the school system (public or private), is a regimented (weekday) schedule.  Early childhood care providers can attest to how adaptable even the youngest children are to adhering to the concept of time, or a routine. For example, there is story time, nap time, and lunch time, etc., which is repeated daily, or on a consistent schedule.  That said, I recommend adopting a weekday routine that mirrors (even if it is loosely based), on what your child is accustomed to during the average school day.  You can even Google some age-appropriate curriculums or activity ideas that works best for you and your child.  Maintaining some form of a consistent routine will help your child once they are able to return to school, and it helps your child’s time spent with the amazing electronic babysitter be more productive. 

But wait…there’s more!

While your child is busy e-learning, this grants you (wait for it…) a few moments to yourself.  *Queue sounds of angels singing while playing harps. *  If your child is old enough to work somewhat independently, I encourage you to allow them to do so.  Of course, you will be there for guidance and to monitor their activities, however (and just like in school), the child is expected to work independently on certain exercises.  Which frees you up to make lunch, prepare snacks, and even get dinner started. All in the name of helping you carve out well-deserved time for you, even if you have to piecemeal your way to finding this precious commodity initially.  And speaking of lunch, please do schedule a lunch period during the weekday for you and your child.  It doesn’t need to be anything elaborate or fancy-just a structured meal time where the child gets to enjoy their food uninterrupted, and you get a moment to enjoy personal time, care, and nutrition.  If your child is under four or five-years-old, maybe a nap is incorporated into lunch time.  The bottom line, the time is already there. It’s now about using time differently to accommodate your personal situation and needs. It’s also about making sure time works for you rather than against you.

You mentioned that your child is “super clingy” and often sleeps with you because of the illness.  Are you receptive to modifying this bedtime arrangement? If so, I recommend putting your child to bed in their room as often as possible.  Given that the child is accustomed to you being there prior to sleep, perhaps you hang out for story time, and afterwards make yourself comfortable until your child falls asleep. Once asleep, you can now retreat to your room or favorite space in the house to have some personal time before bed.  I’m sure it’s more convenient or even practical to allow the little one to sleep with you, versus you having to go and see what’s wrong if something arises during the night.  As the child gets older however, you both will need your privacy, so why not consider introducing or reintroducing this level of independence now, if this is an option?

Children are very resilient as they are smart.  Just like parents have intuition, I believe that children have a similar intuition when it comes to their parents’ needs.  Some children appear to be clingy, or display signs of (or similar to) separation anxiety because they rely on mom or dad for comfort.  There are some instances however, when the child realizes that mom or dad needs a similar level of comfort from the child. At which point some children learn at a very young age how to take care of, or even pacify the parent on some level.  The easiest way to assess if this is true for you or your child, is to gauge how well the child gets along when you or dad is not around. Does the child express that they miss you, but manages to carry on normally? Or, is the babysitter, or temporary caregiver riding like the wind (with a police escort), because the child is too upset and needs to return home-STAT?

That part of yourself which is screaming at you for a much a needed break is spot on. I encourage you to make time for yourself to grow and expand for the sake of your family, and for you. Especially considering that you’re the 24/7 parent right now. From what you have shared, you have nothing to feel guilty about. You are doing the best you can given your circumstances. Which is all anyone (including you) should reasonably expect. As a parent, you’re always teaching your children. Using this example, you are showing your child how to matter. By modeling self-care, the child learns that everyone is permitted to have a form of “me” time. That goes for them, dad, and yes, even mom.

You are also entitled to a break, so give yourself permission to take one often. Something as little as 15 or 30-minutes at a time (daily) will add up exponentially, thus creating the opportunity for you to be rewarded handsomely by way of increased productivity, creativity, and overall happiness. You have the right to use time for your benefit as much as everyone else’s. I hope your child’s health improves soon.

It’s time to say good-bye to those dark circles once and for all, Dolly!


If you would like to submit a question for me to answer via an upcoming Ask RymarkableSteph post, please email me at: RymarkableSteph@gmail.com.

Disclaimer: By submitting a question, you agree that if selected, your question will be posted on the blog anonymously, and may be edited for clarity. All information and resources found on the RymarkableSteph blog is the opinion of the author, unless otherwise stated. Any advice given is based on the author’s own knowledge or experiences, and is not intended to treat, prevent, or diagnose, any medical, or mental health concern. I am not a lawyer, physician, or health care professional. Please always consult with a qualified expert.

A New Enemy Among Us

It’s such a foreign feeling to be apprehensive of other human beings.

As children we were warned about the “boogey man.” And stranger danger. Sometimes we were fed images coupled with descriptors of what a so-called bad person looked like. There may have been role playing exercises so that a child’s naivety wouldn’t put them in jeopardy. “Beware of strangers,” and “don’t accept rides or candy from people you do not know,” our parents warned.

Today, there is a new enemy among us. One that we literally cannot see coming, but it’s presence is formidable as it is legitimate. What’s more frightening is that the “smartest” minds among us can’t thwart it, not even medical science. This enemy is viral. And while it has no specific personified target it seemingly has a mission.

Grocery stores now look like ERs and ICUs, over capacity with a sea of blue face masks, and hands adorned in pastel blue plastic gloves. Recently, and for the first time in my life, I wore a face mask and gloves before entering a grocery store. A grocery store. I caught myself carefully stretching out the fingers of the gloves as I prepped myself in the car, nearly mimicking a climactic scene from a medical drama. Except I wasn’t about to perform life saving surgery. I was trying to save my own life as I was preparing to go food shopping.

This crisis is revealing the most extreme spectrum of responses and personalities. There are those who now visit public places completely shrouded, some donning military-grade gas masks, and other makeshift versions of PPE. And there are others who carry on their regularly-scheduled lives as if they possess a level of immunity that alludes the rest of the planet. They still play contact sports. All but mock “social distancing” edicts, and yet are somehow inclined to stock pile (i.e., disrespectfully hoard) essential food, and household supplies “just in case.”

There are those who still stand dangerously close to strangers in shopping aisles, or other public spaces. These people will all but kidnap your shadow and stand in it’s place, hovering over you as you attempt to make your selections. This behavior is rude pre-corona virus, it is potentially lethal today. No hyperbole here. This is not a game, and it is not a drill.

We’re all in this together. So let’s act like it and do the right things together. More often than not. The lives of others…including your own may very well depend on it. There’s a so-called “threat” out there, and it shouldn’t be one of us.

Be careful out there.

Introducing Ask Rymarkablesteph

I’ve been asked by a few good friends to offer advice on pointed subjects. So, the format will go like this:

A subscriber will ask me a question, consenting that I post the question (anonymously), and response via an upcoming blog post.

As I’m not trying to run a full-on advice column, I will alternate between my regular posts, and a Ask Rymarkablesteph post. I might do a combo. The process is fluid right now. Let’s see what works. If you haven’t already done so, please consider subscribing and commenting, if you are so inclined.

If you would like to submit a question for me to answer via an upcoming Ask RymarkableSteph post, please email me at: RymarkableSteph@gmail.com.

Disclaimer: By submitting a question, you agree that if selected, your question will be posted on the blog anonymously, and may be edited for clarity. All information and resources found on the RymarkableSteph blog is the opinion of the author, unless otherwise stated. Any advice given is based on the author’s own knowledge or experiences, and is not intended to treat, prevent, or diagnose, any medical, or mental health concern. I am not a lawyer, physician, or health care professional. Please always consult with a qualified expert.

Resiliently Coping

As the corona virus pandemic continues to make its rounds, I strongly suggest that other states and cities learn from the East Coast. As you watch the news it may appear as if you are witnessing an optical illusion. New York City streets, namely the infamous Times Square that has been brimming with life since the early days of the city, now eerily desolate.

You see the cars lined up for hours filled with anxious people seeking testing at mobile sites. There are stories of weary medical and health care professionals, working passionately to save lives even if it means compromising their own. There is mandated social distancing enforced by local police departments. There are also grim images of human remains being stored in 53-foot mobile freezers, highlighting the severity of this crisis. Countless celebrities have come forward disclosing their status…and those are the fortunate ones. What we know for sure is this emergency is not selective. It impacts people just like us regardless of income, social status, or other demographic descriptors.

As scientist, doctors, and other scholars work around the clock to understand this virus and identify a cure or remedy, what we do know is this:  this is not a game. This is not a drill.

There are people who wash their hands regularly, and still contracted this virus.  There are people who observed many of the precautions as dictated by the CDC and other health organizations, and they too tested positive for COVID-19.  Do I say this to alarm you? No.  Should you throw your hands up in apathy? Unequivocally not!

What you can do is adapt to this new way of being, interacting, and living for now.  It is be responsible and accountable for our own actions to the highest extent. If you are feeling unwell and interact with other people, if you are symptomatic, or have been exposed to someone with symptoms, or diagnosed with the corona virus, you have the potential to affect every person you encounter. 

By staying indoors as much as possible, you minimize the risk of inadvertently infecting as well as being infected unintentionally. Think on it this way-if you are in your neighborhood (at the store, running errands), you are likely to encounter someone that you know at least once.  If either party has the corona virus, it is almost certain that each person will encounter more people thereby creating a domino effect.   Sometimes we are fanatically trying to avoid strangers, that we forget that everyone is a part of a circle that interacts with other circles. 

All of this indeed sounds like common sense (because it is), however, there is an old and trusted adage about false assumptions around common sense. 

My other tip is to strategically buy household essentials versus panic buying.  Now is also the time for everyone to play nicely in the proverbial sandbox (while maintaining the prescribed social distancing standards, of course.)  As there is no known immediate resolution, any one of us could be forced to knock on a neighbor’s door for coffee, sugar, milk, rice, or toilet tissue (paper)…literally. 

My final point is I know a fair amount of people who have had or have tested positive for COVID-19.  And guess what?  They are alive.  They are THRIVING.  They are at home taking care of themselves and their health.  There are those who are working-business as usual, in public spaces, while taking as much precaution as one can under the circumstances. 

In the cases that I am aware of, these amazing people are going to be okay. 

As I optimistically hope and affirm that all of us will be.

Please remember that your individual actions matter now more than ever. 

Be careful out there.