“I'm going to fight it, but I'll let it live.”

It's been a while since I've updated, mostly because life happened. I started my new job, acquired a new apartment, and basically quit comedy for the time being because those last two things haven't allowed me to travel or know my schedule anymore than two weeks in advance. Maybe I haven't updated because things have plateaued and there haven't been these urgent, bureaucratic developments to report on as the race to a two-year visa is over. I didn't win and I didn't lose the race, but holy fuck did it take a while.

I worked at Comcast in 2012 and 2013 in the company's last departmental resort to retain customers commonly referred to as "Loyalty," but anyone who has worked in the telecommunications industry will know it as "Retention." Between disconnecting or downgrading services, I was sometimes the last point of contact for customers who hadn't been using their OnDemand services like they imagined, or they only watched three of the 450 unnecessary channels for which they paid. Half hostage negotiator and half sales rep, I convinced people to step away from the ledge with three free months of HBO or Cinemax. I didn't feel like I was getting paid enough to be yelled at every day after my training wage dropped from $18.57 an hour to $12, so on my 90th day, I didn't come in. It took a week for them to call me. Since the turn over rate was so high in the "future of awesome," keeping track of employees was an afterthought.

I'm now in a similar situation in Brno. I'm training to be a manager in a call center alongside two others in Bratislava and Kosice, Slovakia. The technical support world is drastically different than that the sad sap, desperate world of retention. With technical support, people actually want their issues solved. With retention, people want to eliminate those issues completely. I went from bargaining to sleuth-like maintenance for customers who mostly live south of the Mason-Dixon line. Their accents are difficult for Czech people to decipher, and the Czech accent is quickly grouped into the generic Slav language pool by those who think communism is still a danger to society. Some of my Czech coworkers even had to change their Moravian sounding names to something more American, like from Djanna to Jane in order to woo the customer into thinking we're all on the same team.

For the last four weeks, I've been in training during the day and I'm now working second shift to align with US business hours. The six to nine hour time difference means no more early mornings as I'm doing my best to help the guy who mowed his lawn ("cutting his grass" as I explained to my Czech colleagues) and subsequently ran over his telephone line, or the woman who is convinced her modem would regain life by unplugging the power cord and leaving it unplugged. As much as I make fun of the southern accent and accompanying etiquette, it's nice to speak with Americans. I'm able to use the entire catalog of my vocabulary and not just the universal basics. One guy even told me he was glad I wasn't from India. I politely explained that our company is multi-national and we employ people with many different ethnicities and backgrounds. He told me, "I like the way you put that." I work with people from Egypt, Israel, Mozambique, Mexico, Ireland, Bosnia and Herzegovina, South Africa, Ghana, Turkey, Greece, and Zambia. Sometimes I feel guilty having the easy calls with even easier communication, but I hope my vernacular can rub off professionally.

Between eating an apple with some crackers for lunch and taking phone calls from properties which used to be plantations, I started looking for another apartment in Brno. I love the place where I am but it's very big for a small town (no one here knows where Seattle is) girl with her cat. I'm basically in a two-story townhouse. The size would be appropriate for a couple or someone whose best friend is always passed out drunk on their couch, but I don't fall into either of those categories. My kingsize bed is just a giant shelf where some of my stuff now stays because it's mathematically impossible for me to reach. I don't have any of my own furniture except for a nightstand. The flat came furnished with a glass chrome coffee table and boxy cream leather couches. It's like the Czech version of Weekend at Bernie's except there's less blow.

The new place I found is three blocks away from me in Kralovo Pole. It's on the fifth floor (technically sixth floor according to Europeans) with no elevator so my legs are about to get...and I think I'm using this right, "swole"? I'm on the very top of a yellow building with a red roof. The tram is about fifty yards away and I have a vecerka mini-mart across the street. It's sunny with windows in my slanted ceilings and it comes with a washing machine, a nook for a full-size bed, and an outdated wardrobe I'm going to call "Spare-Oom." I like it because it's small, not super small in the sense that I would need to disguise its size with the word "cozy." It will be unique to me with my own items and furniture not unique to a Czech cocaine dealer. The transitional housing I've been in was great as a jumping off point, but I need something that's mine. I'm justifying the continuation of my selfishness because I'm the only human I'm invested in taking care of right now. That's why I'm here in the first place. Also my new apartment is almost half of what I'm paying now so I'm feeling pretty good about it. A common thing for foreigners to experience here is being ripped off by landlords as soon as they discover their potential tenants aren't Czech. I was turned away from multiple apartment listings once they found out I wasn't Czech and that I was clearly writing my emails using Google Translate. But eventually I found a place where I can thrive alone and I move in September 1.

Last month I was lucky to have some traveling sober friends in town. We went to the oldest restaurant in Brno for a traditional Czech meal, caught up on program-related aspirations and developments, and discussed current and past travels through Europe. It was fun poorly translating in restaurants and shops, digging through Czech thrift stores for outdated fashion and even further outdated fashion, and not having to worry about the overindulgence of alcohol. My friend brought up that I should get a Czech Big Book (Modry Kniha, or "Blue Book" in CZ) so I could learn the language better since the AA verbiage is the same in every language. The next week I went to the one Czech AA meeting in Brno. I brokenly told the group of five I had moved here from the US and I used to work as a teacher but now I'm working in Bohunice. I told them I haven't had a drink in over three years and where I live, about kitty and my family back home. My Czech is still very "white" as in it's broke and is probably doing more harm than good, but I was able to use the language effectively to find the small sober community here. Due to working second shift temporarily, I haven't been able to attend and I found out there are no English-speaking meetings in Brno, so while I feel isolated, having two sober friends come visit further made me acknowledge I made the right choice. I couldn't do what I'm doing today if I had kept drinking. To be blunt, I'd probably be dead.

In regards to my non-hypothetical health, I'm doing much better than I was back in April. My diabetologist doesn't give me any shit and he trusts me to take care of myself and manage my dosages. He was able to order me the appropriate amount of test strips I need per month and SURPRISE I didn't have to cry on the phone to my insurance, endocrinologist's office, or the pharmacy. Trying to get my health straight in the US was like playing medical Three Card Monte every few months while the institutions play this circular blame game of finding the designated person to help me. Pharmacy says I need to talk to my doctor, doctor says I need to talk to my insurance company, insurance company says I need to talk to my pharmacist. If I need any prescriptions in CZ, I email my diabetologist, I pick up the slip, take it to the pharmacy, and they give it to me on the spot, no questions asked. Insulin only has a 30 day shelf life if it hits room temperature so moving a large supply by public transport can be tricky. Every time I pick up insulin, I also buy frozen veggies and berries to keep it cool on the sometimes 40 minute ride home. That's honestly the worst part about all of this. I'm sure there are easier ways to do it but I like making things hard on myself.

My dad told me about a story that was on NBC Nightly News last week about "black market insulin," something I was partaking in before I left last fall. Because the cost of insulin has risen over 1000% since 2006, the diabetic community has taken to Facebook and Reddit in order to seek advice and supplies that aren't prescribed by a doctor, which fortunately isn't illegal. One of the stupid things about diabetes is that we have to get refills for something we're going to have for life. Countries with universal healthcare sometimes give diabetic patients a pharmacy card that they simply show to the pharmacist to get the drugs and supplies they need to stay alive.

Alas in the United States, diabetic patients are turning to GoFundMe as their health insurance provider because the pharmaceutical industry knows we have to pay for insulin and going without is not an option. A guy in Minnesota aged out of his mom's health insurance plan at the age of 27 and struggled to pay for his insulin. He didn't meet his fundraising goal and he died. Other stories include diabetics rationing their insulin and up to 25% of people with the disease admit to cutting back because of the rising costs. Doing so can lead to blindness, kidney issues, severe nerve damage, liver failure, and DKA, the point where your body can no longer handle the excess glucose in your system and starts shutting itself down. Some people say I overreacted. Between a bad break up, losing my job, and having the repeal of Obamacare pass in the House, I couldn't stay in the US anymore. That entire day scared the shit out of me. No one believed it would happen. And it did. That wasn't a risk I was willing to take. 

Fuck this guy.

Last week I went to buy some frozen food before picking up my insulin and I paid $6 for a $2,300 supply. I had wanted to live abroad for years and now was the opportunity, not for my life but also literally for my life.

It took ten months to the day, but I finally have my job, my kitty, and my apartment. I'm excited to have my own blank canvas and not have to share any of my square meters with a roommate. I'm going to build ledges in the skylights so kitty can have a place to perch and modify a bureau that's unique to me and no one else. It took forfuckingever but it's finally coming together. It's been exhausting trying to relax. I can't wait to get back to the point where I can stop caring. You know, in a healthy way.

Czech Healthcare Adventure! Part II

I've been on a real Bob Ross kick lately. My mom used to watch it when I was a baby and my grandfather painted along to his happy little creeks and cabins with roofs full of snow in his old age. There's a Twitch stream that plays all of the episodes, even the ones where Bob's son and his glorious mullet do a guest spot. I go to sleep at night listening to Bob describe a squirrel he rescued and named Peapod and his soothing ramblings about combining colors, techniques, and tales Florida and Alaska. It's very zen, something I've sought after for much of my life. 

YES, YES THEY ARE.

Today I went to my first "diabetologie" appointment. The Czechs are specific when it comes to medical care, meaning that instead of seeing an endocrinologist like I would in the US to treat Type 1, I see someone who specializes in only diabetes and not other endocrine disorders. It was a relief knowing I wouldn't have to explain my disease to a professional who may not know all of the ins and outs of dosages, regimens, numbers, and time tables. Unfortunately, this has happened before. It's like if you woke up during open heart surgery and told the doctor "here why don't you let me take over for a bit."

St. Anne's University Hospital, or"fakultni nemocnice u vs Anna v Brne" as I've learned to refer to but not pronounce, is a sprawling campus of old Soviet buildings, newer, pristine architecture, and baroque moldings near the center of Brno. The map I downloaded to find "Building J" was color-coded but also in Czech, so I did that thing where you walk one way while watching your location on GPS to see if you are indeed heading in the right direction. Building J did exist, however it was quite a hike around the campus to locate it. At one point I wondered if it was maybe like the Back Building in Mean Girls.

With a low ceiling and steel chairs lining the hallways, I wasn't sure if I was going to a diabetologist as much as I was going to be contacting any form of asbestos. These hallways had seen better days with their scuffed patterned floors and shredding yellow and orange wallpaper.

On Pinterest it might be referred to as"Shabby chic!" I found a hallway full of doors and outside each door was a vinyl bench with no form of support.

The door with my doctor's name on it had people going in and out of it so I figured this must be a good thing. They're not being wheeled out of the room with a respirator or a blue face. So far, so good.

Like if this room was a hospital.

I have now spent enough time here to know that when you see a chair or an area for waiting, that's where you wait, which sounds obvious but if you go further to investigate behind doors that aren't marked clearly, a woman named Petra may scold you in Czech until you just sit anywhere close by until you're officially retrieved. So I sat and waited outside. 

For Czech people, my last name is pronounced "Dawn-uh-hoo-ee." With the stress on the first syllable and no accessible diphthongs, I've learned to listen for various covers of my surname from people I don't know. A young nurse fetched me and my seemingly normal last name from the hall and brought me into a large examining room and office which didn't look like it belonged inside the semi-decrepit Building J. Brightly lit with new furniture, recently manufactured medical supplies and machinery, and surfaces free of dust or minerals, the nurse who spoke some English informed the doctor I had Type 1 and that I needed a new blood glucose meter and the appropriate test strips. Certain test strips only work with certain meters, and since I couldn't buy strips in Metric meant for an Imperial Measurement System meter, I needed a whole new kit. They spoke back and forth in Czech for a moment and then came the question: "Insurance?"

I signed up for state health insurance after my visa was approved, but my insurance card still hasn't arrived in the mail. I also didn't have anything on me that proved I was technically in the system, so in this circumstance, I basically didn't have insurance at all. I showed them my traveler's insurance, which only covers you in the event of a nuclear apocalypse or emergency treatment upwards of $200,000, but they shook their heads. They continued to talk in Czech as I brought out my bag of supplies filled with both types of insulin, spare needles, my glucose meter, and test strips. I could have just been some random person who came off the street, so I wanted to show them that I currently have the supplies needed for someone with Type 1. In broken English, the nurse said, "We give you a meter and test strips free, and in two weeks you come back when your insurance card comes, yeah?" 

Umm, fuck yeah. I smiled like an idiot and said "ano, ano prosim." Getting a free glucose meter and the accompanying strips in the United States means getting one from a diabetic friend or selling your first born and sometimes second born. One of the reasons people with diabetes let their care suffer during a financial crisis is because they simply can't afford the test strips, let alone the insulin. I test my blood sugar four to five times a day depending on when I'm eating and how long I'm awake. In the United States, a pack of 100 test strips without insurance is $129, meaning every 20 days, I'm out $129 if I actually want to manage and treat my disease instead of slowly die. Test strips are a HUGE inconvenience. You need them to figure out how much insulin to give yourself before meals and to find out if you really do have low blood sugar or if you're just imagining it. Getting 100 of them for free in addition to the hardware is a big deal. 

Woo! Czech glucose meter!

The nurse who spoke some English and another nurse who spoke zero English physically acted out how I'm supposed to use the meter. Even though I've been testing my blood sugar for almost eight years, I couldn't bring myself to stop their comedic safety demonstration. The Czech nurse poked her finger and said "owwwiiieeeee!" and then blew on it to exhibit the minor pain and inconvenience of pricking myself. "Into blood!" Aren't we all. They packed up my new kit and sent me into my doctor's actual office where he asked me some basic diabetes related questions: when were you diagnosed, at what age, what symptoms were you experiencing, how often do you go low, and which insulins are you on. I brought out my bag of supplies and showed him the insulins I use. One insulin I use is what's called a basal insulin and lowers me to a healthy "baseline" for 24 hours.

I use the other insulin before meals or when I'm consuming carbs, which can only be done every 4-5 hours. 

He recognized both pens and told me he would give me prescriptions when I came back in two weeks once my health insurance card had arrived.

Basaglar and Humalog, the two insulins I need to use.

Insulin pen with a teeny tiny needle.

Then my doctor told me, "I'm not going to charge you for today since you only needed a meter and there's no exam. When you come back in two weeks, your insulin prescriptions and the appointment will be covered. If you need any lab work done, that will be covered, too."

I was floored. I smiled at him and almost cried. Normally in the Czech Republic you need cash in hand, although not much, before any medical appointment if you don't have health insurance for your visit. I was expecting to pay something today, but not nothing. If this was the situation in the United States, I might need to start a GoFundMe to cover the costs of staying alive. I told him that it wasn't this easy in the US. "We know," he told me. 

Finally, a country that understands that staying alive is a basic human right. If we were brought into this world without consent, there should be an economic and social system in place to make sure we can be the healthiest capable people contributing to society. Why is that so hard to understand? If the US has such a hard on for being the greatest economy, shouldn't we have a healthcare system in place that takes care of the people who put forth the effort and time to stimulate a "great" country?

After gleefully leaving the hospital, I literally skipped back to the tram stop and went to teach for the afternoon. I showed the other teachers my new rig and spent the next few hours going over phrasal verbs, how "synonym" and "cinnamon" are two entirely different words, and the correct pronunciation of "hyperbole." I'll update again in two weeks after my next diabetology appointment. If the Czechs keep taking care of me like they are, I'm going to be here for a long time. 

Red Pill vs. Blue Pill

Woo! My visa has been approved! 

With a long stay visa, I'll be legal to work in the Czech Republic for the next year. I have a few more bureaucratic things to take care of in regards to getting paid, but the waiting and the hard part is over. A year from now, I'll need to reapply for two years after I prove I'm able to support myself being independently employed with my trade license. The schools I currently work for allow me to teach as a contractor, meaning I'm responsible for my own taxes, health insurance, and future visa processes. 

It's a huge relief. I've heard these horror stories of messy visa applications with different contracts and the length of stay available to expats and so far I've done my best to avoid that. One of the complicated things about visas is that no one situation applies to everyone. While I was doing research before I left the US, I was getting an insane amount of misinformation from people who assumed I was from the EU or that I was already a Czech resident but not a Czech citizen. CZ separates expats and their rights by where they come from. For instance, members from the EU, people from the UK, Americans, Australians, Canadians, and other citizens labeled "third country nationals" all require a different visa process to apply for residency or for work. My dear friend KD swooped in during June of last year to alert me to her existing troubles as an American abroad. She highlighted details given to me that were incorrect and struggles she encountered both in CZ and abroad to steer me in the right direction. I'm infinitely thankful for her and I couldn't have completed this exodus without her. She's also been extremely real with me in that she explains things about Czech bureaucracy with no sugar coating. I'd rather someone be up front with me and be brutally honest than leave me in the dark to figure out these processes on my own. The truth can hurt, but it makes for good progress in the future. 

Prior to receiving the email regarding my visa approval, I went to my first therapy appointment since October. I had done some research about who to contact before leaving the United States but hadn't bothered to contact anyone until about two weeks ago. Therapists generally don't take health insurance in CZ and just do a flat rate for one hour, which alleviated me trying to find someone who takes my non-existent insurance but won't break my back. In USD, prices average out to about $20/hr. In the past, my therapists have been anywhere from included in the cost of my health insurance or their rates were north of $130/hr. There also seems to be a sliding scale with bilingual therapists where the cost is lower in Czech but a few more crowns if you require an English speaker. 

Bretislav is a mix of Hopper from Stranger Things and a Czech version of Dr. Frasier Crane. I had seen his picture online when I was looking for therapy options in 2017 and like a lot of comedians I know, they look incredibly different from the professional headshot they've loosely been relying upon for a number of years. He listed his credentials and his areas of expertise, which is important when seeking out therapy. Two years ago I had made the mistake of going to therapy with someone who wasn't keyed in about addiction, the recommended treatment involved, and the after effects of staying sober. I ended up having to explain a lot of facets of AA and how the recovery system works, which was fine, but needing to contextualize addiction within my anxiety and depression proved to be fairly difficult. I was relieved to see Bretislav specialized in all three areas. 

We emailed back and forth about finding a time to meet and I met him at his office. His entire workspace was larger than my last apartment in Seattle. Fifteen foot high ceilings (or roughly four meters?) and tall windows allowed for a lot of natural light to be complemented by bright hardwood floors and off-white walls. He had two IKEA swivel accent chairs facing each other with a coffee table separating them. Books in Czech and English and plants I assumed were fake decorated his bookcases. After seeing the entire arrangement, I went into design mode and mentally reorganized his space with my belongings to my liking. The space would photograph well. 

Bretislav sat across from me with a pen and a legal pad. I've been trying to figure out where the fuck to get yellow legal pads in Brno since I've arrived but I was determined not to be distracted during our first meeting. He asked me a few basic questions and explained that there are some complexities in the English language he may not understand so there's a chance I'll need to clarify on occasion. I've had to do this a lot in CZ since I've arrived and doing it for the person treating me for my emotional free-for-alls didn't seem like too much to ask since he'll need to understand me on multiple levels. I talked about where my issues stemmed from: my parents' divorce, dating men I shouldn't as a result, alcoholism, mentally taxing diabetes care, feelings of inadequacy, running away from my problems and my severe fight or flight instinct, and the general idea that I am not enough and I never have been. Of course a lot of these things are going to take longer than 50 minutes to delve into, especially when talking at half the speed I normally talk to ensure no one is lost in translation. 

Because it had been so long since I've spoken to an impartial party, it became overwhelming to not leave out any details about why I scheduled an appointment. I wanted Bretislav to know everything immediately so he could stamp a diagnosis on me or lend me resources to curb the things I've been told are wrong with me, my faults, criticisms, and critiques. I explained how a recent text from an ex-boyfriend threw me for a loop of would have/could have/should have hypotheticals and how it has led me to second guess a decision my mom once deemed "dramatic." From what I understand, a lot of expats experience this phenomenon. Moving abroad is easily the biggest decision we've ever made, maybe behind on deciding which university to attend or other life struggles I'm unaware of. We start to examine all of the different paths our lives have taken, what prompted us to pack up everything important, sell whatever wasn't important, and uproot ourselves from the life of familiarity we no longer desired. 

But this wasn't just a "well maybe if I wasn't so irrational, we'd be married" situation. This was a "maybe I should have continued my studies in Art History and applied for graduate school abroad" situation or a "maybe I should have picked a profitable major and ignored all of my creative impulses so I'd be rich but boring" possibility. It wasn't the text I received at 4am; it was all of these paths culminating into a Czech nexus of uncertainty. I'm happy I'm here and I'm happy I made the decision to move. It feels selfish from time to time, but ultimately the path I'm on right now seems to outweigh all of the others, and the part that bothers me the most is never knowing what could have happened if I took a different path, leading me to feel guilty and ashamed.

I tried to explain all of this to Bretislav in the five minutes remaining in our appointment and he politely reminded me that if I decide to move forward with his services, we'll have plenty of time to discuss the events and neuroses which make me a human being. After all, whatever has happened will stay that way. Things that have happened to me can't erase themselves no matter which country I run to. Sometimes I wonder if I didn't move east enough. Instead of being nine hours ahead of Seattle, I should be 14 hours ahead and living in a yurt with a dirt floor and a couple who does all of their hunting with a trained eagle out on a vast steppe. But choosing to live in a yurt means little to zero access to insulin, so here we are in Brno.

It's been an emotional week. Now that my visa is done, I can acquire Czech public health insurance. I used my credit card for the first time since I've been here to pay for medication for the next four months - $130 for a four month supply of Cymbalta and Wellbutrin with no insurance. In the US, a 30 day supply of Cymbalta alone is $260 without insurance. Even though my costs are cheap in comparison to the United States, I'm happy to know I can officially begin this process, as it's a lot of the reason why I'm here in the first place. I gotta take care of me, and sometimes I forget to do that.

Some resemblance of an actual life here in Brno is beginning to emerge. I'm no longer in visa limbo, I have access to an incredible network of doctors and specialists, and I can legally acquire income to support myself. The first few months have been tough because most of my savings has gone towards paying rent without receiving anything in return as it was illegal to get paid. I can go forth and be productive! And I have incredibly amazing things on the horizon. On Wednesday I leave for Poland for a five day tour with two amazing female comics from Prague. Our journey will take us to Wroclaw, Lodz, Warsaw, and Krakow with an extra day to do some sightseeing. Poland has similar costs to CZ so we won't be going broke and our accommodation is with other comedians, meaning new friends and neighbors. Another American expat comedian in Poland is helping us coordinate travel and costs with different venues where we're performing. I can't wait.

So in hindsight, wanting to have a solo adventure in my life isn't bothering me; it's all of the unknown adventures I'll never know about that could have been possible. 

“So you're a Lebowski, I'm a Lebowski.”

I’ve been having trouble starting these blogposts. It’s unlike me to struggle saying anything that’s on my mind, but for some reason when I begin this first paragraph, it has become difficult to relay my thought process. Perhaps it’s because this is THE NEW YEAR’S EVE POST but when you’re sober, you don’t really take these "holidays" seriously. So maybe it’s the residual pressure of having to report on 365 days of…whatever.

This year started off with a relationship I wasn’t expecting myself to get into. It’s incredibly easy to date comedians, which is why I dated yet another comedian later in the year. It’s like when smokers go out to smoke but they don’t know each other. They immediately have a sense of camaraderie because they’re smoking anonymously. It’s the same for comics as any other artistic form of expression, I imagine. But it’s hard to not shit where you eat when all you’re doing is comedy. Like let’s not pretend I don’t know about it, because I do. I’ve dated a few comics. Some of them ended in a real Hindenburg type explosion but others softly glided down to an even relationship homeostasis. For a real paycheck, I was labeling, measuring, describing, and slinging mid-century modern furniture to people who had never been exposed to the design form everyone over the age of 50 is relatively sick of. The consignment shop was reminiscent of a pawnshop owned by Don Draper, but most of my time was spent listening to Creedence and try to upsell people on the experience of a reversible sectional sofa versus a love seat with no accompanying ottoman. For forty hours a week, sizing up furniture and thinking of ridiculous names that had significance to me but was beyond imagination for anyone else visiting the vast array of uneven concrete floorspace.

March rolled around and life’s challenges became unusually stressful both mentally and emotionally. It was around this time last year I was having conversations about wanting to better myself in terms of what I ate, how I exercise, and what I deem a healthy amount of sleep. And in the new year, I became obsessive over numbers: units of insulin, calories, carbohydrates, minutes spent expelling energy, low blood sugar, high blood sugar, pounds on the scale, inches of my waist. I unknowingly started to go through something called “diabetic burnout.” At some point many diabetics will experience the notion of feeling like they can’t go on because of their disease. They become tired over the mathematical labor it takes to act as your own pancreas, so their diligence becomes lazy and worn out. Except my burnout was the opposite. I was overzealous with my equations in the kitchen that doubled as my laboratory. If you take one pound of cauliflower rice with X ounces of protein over four days divided by Y sodium preservative sauces from Trader Joe’s, how many times will Liz cry by the end of the week? I wanted to be accurate and exact. I couldn’t turn into the diabetic person who is the case for the misinformation most people receive about the disease. I didn’t want to lose my toes. I didn’t want people to see me as someone overweight and finding out I had diabetes and saying “Oh yep, that makes sense.” I even pulled out of a comedy show that required me to strip to my degree of comfort. “Comic Strip” looked fun and exciting and it was refreshing to see a comedy show that didn’t involve smoking weed or drinking, and at the time, it felt like most of these comedy shows weren’t for me at all. My self worth was at an all time low and I couldn’t get a break from the autoimmune disease taking up so much of my brainpower.

I started contemplating killing myself. There wasn’t a cure and there most likely won’t be, so why slog through the next 40 years at limited capacity? At first, I didn’t know how I’d go about it, but I narrowed out things like using a gun. I didn’t even know where to get a gun. Knives seemed drawn out and painful and the IKEA brand stainless steel edges weren’t going to be effective. I thought about using medication but I didn’t want to have my last experience in life be that feeling where you take mushrooms and then just sit there idly waiting for them to kick in. I was too short for the rail in my closet. This insanity in itself was exhausting, and I ended up mentioning it to my endocrinologist, who submitted me to the ER when I told her the ideations I was experiencing. I was crying a lot, tired, dragging my feet. I was at my appointment in sweatpants and the slippers I wore to rehab because I stopped caring about my outward appearance when I wasn’t on the clock. I looked like I had a drug problem with all the drugs I wasn’t actually on. I was losing my hair from being stressed, I stopped wearing make up, and I rarely responded to text messages.

My endocrinologist walked me to the ER where my mom met me. I’m the only one in my family with diabetes so before my diagnosis, no one had any familiarity with the disease, and a lot of my stress manifested through having to explain to everyone around me why I couldn’t have dinner yet, why I was sweaty and clammy behind the wheel of a moving car, why I’m eating dessert after dinner before everyone else, why I needed to stop at the 7/11 for extra Skittles to keep in my glovebox. I explained to the ER social worker person (I’m clearly still unsure of her exact title) who met with me that I wasn’t in danger, I’m just tired and frustrated I can’t have a break. I told her I’d rather have cancer since I’d maybe have a chance to beat it. I told her that my life was narrowed down to prescriptions and the fear of President FuckFace ultimately making it so that my life would become completely unmanageable while living in the expensive, Amazonian oasis that is Seattle. I spilled out all of my fears, frustrations, all while trying to stay sober at the same time. I went home and called my boyfriend, who scolded me for not telling him of my ideations sooner. I had spent six hours under the care of medical professionals and when I finally returned home to the small closet I was renting on Alki, I was essentially shamed for having any kind of emotions. It was a real “I’m not sad, just disappointed” kind of vibe. Looking back on it, I understand his concerns. But at the time, it really wasn’t what I wanted or needed to hear.

I returned to my job at the consignment store the next day and was promptly laid off. The store had been hemorrhaging money to make it a competitive environment for people who wanted to buy and sell furniture. But with the economy the way it was, people were more interested in receiving money for their flatpack crap they had lying around for months in a damp garage than spending money on a cosmic shaped couch dubbed “The Jetson.” This was the third time I had been laid off in my life and the only one where I remained sober of the rest of the day. I was becoming overwhelmed, aimless, and unclear about how to proceed, so I ended my relationship, deleted Facebook, and I wish I could say I hit the gym and lawyered up, but instead I resorted to eating cereal twice a day and sleeping through the literal days of my two favorite seasons. I quit comedy for roughly six weeks. The last thing I wanted to do was present my unpresentable self in front of a bunch of my peers and a bunch of strangers. My sense of routine was demolished, but finding a routine elsewhere and doing the research to find some structure wasn’t completely out of reach.

90% of the time before I go to sleep, I’m on Reddit with my phone three inches away from my face. I scroll through the qualms of history and Seinfeld gifs retrofitted to current politics. The expat subreddit came up, r/iwantout, and I looked at the kinds of questions people were asking about moving abroad. I had wanted to move abroad for years but never did the thorough Googling it entailed, and since I had all the time in the world in the middle of the night because I didn’t have a job or a relationship, I slowly started compiling information about the former communist bloc country now known as “Czechia” except no one calls it that. Like I’ve stated in this blog before, the reasons I moved were preserving my quality of life and improving my cost of living. Being an insulin dependent in Seattle without health insurance was going to be a gamble. So I did what Reddit suggested. I got out.

At first my decision was met with extreme hesitancy. “The Czech Republic? That seems drastic,” my mom told me. And over the next few months, I completely inundated her with information about cell phone plans, rent, the language, transportation options, healthcare in the US vs public healthcare in what was going to be my new home, geographical points of interest, how far away I was from Russia and the Ukraine, and carb counting on the metric system. While my mom was concerned, my dad was pleased. I was almost 30 and reached a point where I was no longer clinging to anything in Seattle. No boys. No future in comedy. No job. I made a list of reasons I would return to the US; a family member getting seriously ill or dying, zombie apocalypse, or an outbreak of nuclear war were all reasons to book a ticket home. Some people estimate I’ll be gone forever. Others estimate I’ll be home by March.

And so here I sit on New Year’s Eve, in Brno, with the sound of rumbling and bumbling fireworks all around my concrete home. I wonder how bad the PTSD is here from the multiple transitions of power that took place in this country over the last 100 years. I’m finally living by my own guidelines instead of the false, fabricated, grandeur expectations of others. There’s a lot of verbs I could apply to my situation. I escaped. I failed. I lived. But whatever I’m doing, my ham of a kitty hasn’t left my side and I’m making new friends while learning a very difficult language and I’m staying in contact with my family at home. I’ll be going to a friend’s flat, another expat from the states for boardgames and home-cooked vegetarian food. I don’t know how to sign off on this, much like the beginning of all this bullshit regarding not knowing how to begin. So I’ll say fuck this year. Actually, no. This year wasn’t bad: it was just different. I’m assuming 2018 will progress in the same way. That seems like a good note to end on. Goodnight from Brno, Happy New Year.

Czech Healthcare Adventure! Part I

Today I experienced the Czech medical system as an uninsured foreigner! And it's fucking awesome! When I say uninsured, I mean that I am not yet on the Czech public health insurance that is offered to me as an American expat, the same insurance offered to Czech citizens. I currently have travelers insurance that I paid for upfront for the next four months while I'm waiting for my visa to be processed. This insurance protects me in case of an emergency and extends outside the Czech Republic, whereas the state insurance is only effective within the country itself. After my visa is approved, I'll be able to get on that sweet, sweet state system and reap a multitude of benefits as a diabetic woman with depression and anxiety and a reproductive system.

The one issue/non-issue with the travelers insurance is that hardly anyone takes it. I've scoured the internet for endocrinologists, gynecologists, general practitioners, and therapists who take my insurance, Ergo, with little to zero success. Then I searched for English speaking doctors who are accepting new patients. Google's reviews sent me to the guy I went to today and I've been smiling like an idiot the whole afternoon. Not to mention booking an appointment with him was incredibly easy. I chose a time slot on his website and I showed up.

I should note that depending on your affliction, you'll need to see certain doctors for certain things. For instance, I can't get my birth control from a GP, so I'll need to make an appointment with a gynecologist. I was unsure what the case would be for both my Wellbutrin and Cymbalta, a cocktail of which keeps my neurotic and anxious tendencies at bay. Who would I need to see for this? An actual psychiatrist? If today's guy couldn't do it, then I'd be able to get a referral. Just one more extra step.

Living in Královo Pole means I'm in this nexus of Brno tram lines and busses that can take me pretty much anywhere within two stops, and this morning I only needed to take one. I also stopped at the ATM to withdraw cash for my appointment since I'd have to pay out of pocket in case my insurance wasn't accepted, which it wasn't. I stammered a bit trying to figure out how much to withdraw. $100? $3,000?

I realized I got caught up in my "Americanness" because I was assuming a doctor appointment was going to put me into debt or at least reinforce a ramen-style eating habit until further notice. Americans are so used to sacrificing shit just to pay for their healthcare. If I lost my insurance while living in Seattle, my life would have become unsustainable and I'd be working just to afford all of my medications I can't go without. The numbers were staggering after looking at them. It was scary and it lit a pseudo political fire under my ass to protect myself. So here we are.

Dr. Otsar is located in an intricate webbing of tram lines near some of the universities. Lots of young people were milling about in their white sneakers while drinking Red Bull and snickering at what I assumed was me. I found the building and went up to the third floor. The waiting room had six Poang chairs from IKEA so I parked myself and hoped that someone would attend to me based on the absence of windows to the actual clinic. A robust redheaded woman came out of a very white closed door and barked Sit, you wait at me. So I sat and waited. Other patients were coming to and from the waiting room and were seen before I was, but I figured this was because I was new. One thing I did notice was that whenever someone entered the room, they were greeted.

Dobrý den!

It was like entering a room with a surprise AA meeting on the other side. I followed suit and did the same for whoever showed up. Normally in an American waiting room, you're sizing up the other patients wondering what's wrong with them and you feel fine after a minute or two but then you hear a loud sputtering wet cough that everyone will leave with by the end of business today so a really great experience overall. 

Dobrý den!

The redheaded Czech Trunchbull came back out and asked me for my ID and my insurance card. I gave her my passport and showed her a picture of my travelers health insurance card on my phone. She waved her hand dismissively at me and said No Ergo. You need pay cash. 300 crowns. Through a thick furrowed brow, she looked saddened or disappointed to tell me this.

300 crowns? What is 300 crowns? 

Czechs have a monetary system based in the hundreds or thousands for the average transaction, so even though the written numerals printed on the banknotes should have a comma in them, this was business as usual. 

300 crowns = $13.63

Am I actually seeing a doctor for less than what most airport sandwiches cost? Not to mention that, but this is WITHOUT insurance? How is this possible? 

I waited around for about an hour or so and when I was called back, I discovered the English speaking doctor who was praised on Google for speaking English spoke very rudimentary English. Armed with paper prescriptions and medical records, I entered what looked like what used to be an old Eastern European classroom with an exam table. Dr. Otsar was wearing a VERY tight and white v-neck sweater and equally tight white pants because I guess he wanted to give off a vibe that while sterile, he still has style. He took my height and weight in centimeters and kilograms and spoke slowly with me. He asked me

So what is your problem?

I lethargically explained I had just moved to Brno and was looking to establish care. I told him I have Type 1 diabetes and he looked amazed at me for a moment.

Inzulin dependenti, yes he said to me. I'm not sure if it's because he didn't expect me to live this long as an American with the shitty health insurance I had or what it was, but it was though I appeared to him as a miracle of modern science in this office with very thin windows and very fluorescent lights. I gave him my handwritten US prescriptions for my diabetes supplies as well as two bottles of Cymbalta and Wellbutrin. He explained that I need to see a diabetologist, a term I hadn't heard of prior to researching the Czech healthcare system, and he wrote me a referral to someone who he thinks might speak English. That'll do.

He then checked the time on his hilariously huge digital watch and turned his attention to my prescriptions for depression and anxiety. On the tram ride down, I imagined the questions I'd be asked involved my history with these disorders, how long I've been on the medication, who prescribed them to me in the United States, you know, typical doctor questions. Instead, he didn't ask me a single question. None. He pulled up his catalog of medications in some kind of a Czech formulary and gave me prescriptions for two months in less than five minutes. I think having the medications themselves with me helped the process along and I didn't have to explain, and very slowly, that without these scientific creations, I am not a functioning member of society no matter which country I'm located. His last order of business was ordering blood work for me on a sheet of paper much like what I'm used to seeing back home. He checked different boxes for which labs were needed and handed it over to me. Okay, 300 crowns. I pulled out a two-thousand dollar bill which sounds fucking ridiculous but that's what it is. He gave me change, thanked me for coming in, and told me to come back after I had been fasting for 12 or more hours to complete my blood work. This CAN'T be this easy. Can it? WITHOUT insurance? With zero insurance. $13 and I'm out the door? With a prescription for two months? 

I stopped at a cafe near my flat for a quick...bread with cheese and egg and salami and pickle on it before heading to the pharmacy. There are pharmacies everywhere noted by their big neon green crosses, like a beacon of a good healthcare system! The only other time I had been in a European pharmacy was when I got bedbugs in Vienna. I went into an apotheke near my hostel and mimed to a pharmacist using my fingers as pinchers that I had been bit and needed something to make me less itchy. He gave me a German ointment to slather around my wrists, ankles, and stomach and even though I was completely miserable, the experience was noteworthy for future reference. 

I entered a pharmacy chain called Dr. Max, which is very clean and green and pristine. Three pharmacists had their own workstations with a computer and a phone. There was no singular pharmacist up high, towering over everyone with malaise and discomfort underneath. It felt like walking into a mobile phone store. They each greeted me.

Am I on a game show?

I gravitated to the pharmacist closest to me.

We greeted each other with Dobrýden! and I slid the prescription across the counter like I was withholding something sinister when really I'm just a foreigner who doesn't speak much Czech trying to access prescription drugs. He did a few quick motions with the computer and turned back to me disappointed, much like the Czech Trunchbull had earlier. He spoke a bit in Czech and while doing so he realized I didn't understand, so I asked him 

Mluvíte anglicky?

In English, he said he was sorry to tell me that I would need to come back tomorrow for my prescriptions as they weren't in stock at the moment. The look on this guy's face was usually saved for parents who needed to tell their kids that beloved Freckles or Froofles "went to visit the happy little farm" while they were in school that day, or an American finding out that their health insurance costs were going cause them to go bankrupt. I almost was 180 degrees turned to leave when he told me that the costs were going to be 600 crowns. Fucking WHAT. So if we double our math from earlier, two months of two different prescriptions will cost around $27, which brings today's costs to about $40. Without insurance. In the US, today alone would have put me roughly a thousand dollars in the hole. 

It's been a few hours since my first healthcare adventure in the Czech Republic and I'm still blown away at the amenities and services available to me as a foreigner who has yet to access public health insurance. The language barrier is proving to be a bit jumbled but with the right terminology and speed at which words are spoken, it should solve itself as it did today. I was scared going into this morning. I needed to make an appointment and see someone about my prescriptions before they ran out, and even though I'm still unaware of when my visa will be processed or when my public health insurance will go into effect, I was still able to accomplish my business and more.

I will still need to navigate through the thickets of endocrinology (or diabetology?) and the gynecological bureaucratic systems, but considering I've only been here for a little more than two weeks, I've made significant progress. Right now I'm working on this post and kitty is curled up in my blanket I was using for a pillow. I lit a couple candles and I'm going to make garlic broccoli for dinner. I'm not beating myself up about high blood sugars; I've had a few meals where I've been over 300 but I'm chalking it up to the fact that I'm underestimating the carbiness or sacharidy of the fucking squishiest bread loaves in the world. Yeah, I'm insulin dependent. I'm insulin dependent as fuck.

I'll keep updating the further I navigate. But as an introduction into the Czech healthcare system today, I'm incredibly happy that I can be healthy here.