Look, Getting Sick Isn’t Always Optional. Rebecca Bloom Wants You to Get the Support You Need
Show Snapshot:
Midlife straight talk alert! Hitting midlife means health scares become reality—for you or someone you love. Rebecca Bloom, lawyer and 26-year patient advocate, wrote "When Women Get Sick" after navigating her mother's breast cancer journey and helping thousands of other cancer patients do the same in a healthcare system that wasn't built for women. Look, no one wants to think about illness and disease. But when the sh*t hits the fan, you want to know how to get, afford, and keep the health care, insurance and workplace benefits needed to help you survive. We cover must-know info like—How do you choose insurance that protects what matters? What's your script when bills are wrong? How do you turn your doctor into an ally? What creative solutions exist beyond insurance? How do you appeal denied coverage successfully? Why should you "assume partnership" with HR? Listen in for a conversation on being a smarter patient—knowledge is power and peace of mind!
Show Links:
Follow Rebecca:
Rebeccas’s Book:
When Women Get Sick: An Empowering Approach for Getting the Support You Need
Quotable:
“Unless you have an incredibly high price concierge doctor, the healthcare system we have in place is designed to leave you holding the bag."
Transcript:
0:00 Katie Fogarty: Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, we are exploring a big idea today, but it's a hard one, so stick with me. We are exploring what to do when you get sick. And notice I said when, not if, because hitting midlife, going and growing and aging, means that health issues crop up and need to get handled—biggies like cancer, heart attacks, smaller stuff as well. But even if you yourself are fortunate enough to avoid the big scares and the truly gnarly stuff, odds are more than good that you will watch a bestie, a sister, your mom grapple with a major medical challenge. But here is the good news: when the bad news arrives, you are going to be savvier, smarter, more equipped to tackle whatever you need to face head-on and with less fear, because you are spending time with a guest today who has written an A to Z primer on navigating the tough stuff. Rebecca Bloom is a lawyer, patient and workplace advocate, and the author of the new book, When Women Get Sick. The book, this conversation, tells you exactly how to navigate our medical system, how to maximize coverage, benefits, and security, and to minimize stress. Too many women go broke, experience negative career impacts, and suffer needlessly during major medical catastrophes. Rebecca is here to change that, so stick around. This one is a do not miss. Welcome to A Certain Age.
Rebecca Bloom 1:38: Thank you so much, Katie. I'm so thrilled to be here.
Katie Fogarty 1:42: I am very excited. This is a tough topic, but it's so important, so needed. I have so many women in my life who probably could have used this book when they had that diagnosis day. You have written a book that none of us ever wants to need, right? And frankly, it shouldn't be necessary. We should live in a world and a country that supports and cares for people when they fall ill, but we all know we are not there. So let's start with some stage setting. Why are women in particular more vulnerable to financial and healthcare catastrophes when we fall sick? What are some of the factors that can make us uniquely vulnerable?
Rebecca Bloom 2:20: Great question. And look, there's stuff in this book that can help men too, and I hope that some men read it and that it does help them. But the fact remains, women have some very unique challenges. The first is the financial challenge of being more underemployed, economically marginalized. You and I talked once about how people jump in and out. They do gig work, they do different things. Women are more likely to sacrifice their own career and sometimes, therefore, their own coverage when they're taking care of a complicated group of people, let's say, right, like a family. So that's one reason, and that ripples through in so many ways, in terms of access to care, in terms of being able to afford certain choices, in terms of flexibility about when you can and can't go out of pocket or choose a different doctor, have more choices, right? So that's one very big thing. The second thing, and this is also really a big deal, is that women have been endemically and historically under-researched. There's this statistic that women weren't part of so many clinical trials until 1993. I remember where I was in 1993. It wasn't that long ago, when you think about it, right? And this leads to so many things. There's a lot of extrapolating doctors have to do because they don't really know how something will work for a woman or on her body. And it also leads to later diagnoses often, and that's not just in America. That's everyplace. The third thing, and this is really a big deal too—I don't know if you've ever heard of the podcast The Retrievals, but it talks a lot about this—the dismissal of women's pain. And that's something that really goes to different phases of women's lives, different things that women are challenged by. And then there's kind of the correlative of women being treated like they're hysterical, which is also something that predates our healthcare system. It's baked into history and culture in most of the Western world and maybe other parts of the world too.
Katie Fogarty 4:40: Yeah, that 1993 number always puts me back on my heels, because I was two years out of college then, and I definitely don't think it's the dark ages, but the fact that women were just being introduced in the clinical studies makes me feel like, you know, I spent most of my young life in the dark ages. It's incredible. We weren't counted until that time. Rebecca, your book was so interesting for me to read because it really pulls in a lot of historic data. It pulls in what to do, how to do, how to think. It's charts, it's tips, it's personal stories. You really put a lot of stuff together to create this kind of clear blueprint that somebody can move through. I learned from reading the book, because you share a little bit of your own story, your own background, and your own interest in this field, that to my mind, you're uniquely poised to write this type of book. You are a lawyer. You have an expertise in employee and workplace benefits and protections that people have when they are at work. You've been a patient advocate for 26 years for women with cancers and ovarian cancer. You said something in one of the first chapters of the book that really grabbed my attention. You said, unless you have an incredibly high-priced concierge doctor, the healthcare system we have in place is designed to leave you holding the bag, right? None of us want to be left holding the bag. You learned this the hard way because of a personal experience that you went through with your family when you were helping your mom and dad as she navigated breast cancer. Can you walk us through a little bit how your own career and your personal experience dovetail together, and why you decided to write this book?
Rebecca Bloom 6:16: Yeah, so I really didn't know why I was so interested in that field. Inside of big law, it was a very esoteric little section of a law firm. It just felt sort of human to me, but I really did blunder into it. And then, after I had my first child, I moved to California, and my mom was diagnosed with breast cancer. I came back to New York to help care for her. And I thought I was going to answer the door and collect the flowers and tell people when she needed to rest, and do things like that, but I ended up dealing with the bills, the calls, the "Can I get a second opinion?", the "How do we get an appointment?" And this was all inside of a world where she had pretty good health insurance. My dad is a lawyer. He was super supportive and helpful. And even so, making decisions, understanding the complexity of it all, knowing who to call and how to get the help and how to get things done quickly when you're under that kind of stress, made me realize that I had this skill set that might be useful. So when I came back to California, I walked right into our local breast cancer support organization, which is now called Bay Area Cancer Connections. They went through a rebrand, and I went to the executive director, and I said, "Listen, I know this is a strange question, because I know that my background is a little bit weird, but is there any way that I could maybe help your clients?" And the lady left with glee, because that was pretty unusual for somebody with exactly that background to want to help. Well, 26 years later, it's my longest and proudest affiliation. Who stays anywhere for 26 years, right?
Katie Fogarty 7:59: Well, it's marvelous all around. First of all, you've been doing good work for 26 years, making a difference in people's lives when they're feeling so vulnerable and so scared. And I have a master's. I am married to somebody who has a business degree. And navigating our taxes, the systems, the paperwork of modern life is complicated, even though we are well-educated and have had all the resources. It's still so, so tricky to navigate our systems, which is why this book is so needed. So your book is organized into 11 chapters. Each chapter addresses a very specific aspect of navigating illness. One on dealing with insurance, workplace accommodations, how to communicate to your doctors and your healthcare team. How do you recommend a listener, how do you recommend a reader interact with the book? Do you recommend that they read it to prepare? Should they pick it up when they've had a diagnosis? Should they read it straight through, or maybe skip around to the chapters that seem most relevant?
Rebecca Bloom 9:00: I love that question because I did map it just like a journey, like a health journey, and I did mean for people to skip stuff if it wasn't helpful or relevant. So I'm really glad you asked that question. No one's ever asked me that question before. Also, I don't necessarily think that the person who's sick has to be the reader, because one of the very first things I talk about is drafting your team, and part of your team should be a point person, a chief of staff, as I call her, who really looks at the landscape of what's going to be needed and helps match the right people with the help needed. So I think the book would be comforting to somebody who's sick. It's not scary. You mentioned before, none of us hope to ever need such a book. I was very sensitive to that idea. I did not want this book to be a Debbie Downer, because, as you say, most of us are going to deal with some health challenge. And if it's not us, it's going to be somebody we love and care about who's close to us. So I'm really trying to take away the ick factor and go, "Here are some stories of some incredible women, sentient people, who are going through real journeys, and there's actually some companionship and some communion and some joy inside of this whole process too."
Katie Fogarty 10:22: I love that you described it as a journey. I'm sort of rolling my eyes at myself a little bit, but you know what I mean. It is, right? And it's an inevitable part of life. And you're right. The book is so well-written and so personable. So when you've written a health journey or health challenge or health crisis—I don't care what word I use—it's scary. It's not a fun time. People are vulnerable. Are there common mistakes that people make that you have seen, that you've identified, that people make again and again when they're confronted with scary news? When you're sick, it's hard to think, it's hard to strategize. And so are there common mistakes that people should be on the lookout for, that you can help people avoid?
Rebecca Bloom 11:07: Absolutely. So one of the biggest ones is not having your ducks in a row in terms of your insurance. And it's funny because we get these, I don't know what they call them, but they're the notices that come like on a quarterly basis, this is your coverage, this is what it costs. I talk about in the book how you should actually read those things.
Katie Fogarty 11:28: I'm going to say I've never read them. Yeah, no, no.
Rebecca Bloom 11:31: I don't judge, because I know a lot of people. But the good news is that when you face health challenges, those documents are going to become your BFFs. And so it's good to orient yourself and make sure you have them before you really need them. Because one thing I see over and over again is that somebody will go out of network for a provider and it will be very, very costly. And I'm not saying you shouldn't do that, but you should at least know that that's happening and what the cost differential is, because maybe there's another really fantastic provider who would be appropriate in-network, and you really do want to take that step before you choose somebody. Another mistake people make—I learned this, by the way, and it's pretty gnarly, so I'm going to apologize now. It's that women will sit—and I don't actually know whether this is uniquely female, and I haven't talked to a single man about this stuff, so it's not fair for me to say this is uniquely female, but it certainly does happen to a lot of women. Women will sit on really uncomfortable or weird symptoms, like they'll just sort of not go to the doctor, either because they don't have the time. You know, sometimes you have to take care of sick kids or aging parents. Sometimes people are working multiple jobs. And so by the time they actually sit down and say, "I think I really need to speak to a doctor about this," too much time has passed, and it becomes much harder to treat. So that's actually a very big thing, probably a more profound mistake than some of these administrative ones, but I think very intertwined with it, like who has time to do that? And if you don't have your act together in terms of what your insurance coverage is, then that becomes a disincentive, because you're not sure if it's going to get covered or what the cost is going to be. So there's a lot of interrelated components there. And then the last big mistake people make is they don't ask for help. And that's a big one.
Katie Fogarty 13:37: That's a big one. I really love the entire book so much because you're tackling different parts of this. You've got 11 different chapters, and each of them addresses a really specific need. But one of my favorites was chapter four, which gives sort of how to communicate with your healthcare team, and you offer some very practical, actionable advice. And one thing that you recommend, Rebecca, is that everybody ask three questions. Every time you're talking to your doctors, you should ask these three questions. I'm a TV person, so you know, I'm a big rule of three person. Three is always a good number. You've got your three questions that everyone should be asking every time that they're at a doctor's office or an appointment. Can you walk us through those?
Rebecca Bloom 14:17: Absolutely. Yeah. Number one is, what is my diagnosis?
Katie Fogarty 14:22: I love this because I feel like I never ask that. I always just kind of like, I trust, I just sort of nod, like, okay, yeah, sure, sure. But I never actually do that.
Rebecca Bloom 14:31: Yeah, and I think that's really, I think it's really important to understand what the diagnosis actually is. And the other thing, Katie, that really important about that is the diagnosis sometimes tells you what your coverage is. Like, there are different coverages for different kinds of diagnoses, so it's not just a matter of knowing what it is, it's also understanding sort of the administrative stuff that goes with it. And then the next thing is, what do you recommend I do? And this is important, too, because some people may assume, well, the doctor's going to give me the best advice, I just have to take that. But actually, the doctor might offer you two or three or four options, and what the doctor thinks is best might not be what you actually need at a certain time in your life. This is especially the case with moms with young kids, because sometimes a procedure will take you out of commission for a long time, and there are some women who feel like I need to be in commission right now. I need to wait a little bit until I do something different. The other reason that this question is so important is because sometimes doctors make an assumption about what's best for you without understanding your financial situation. So there may be something that they recommend that's going to be very, very costly, and you should understand that that's the case upfront. And the last thing is, what questions have I not asked you that I should be asking? And that last one's really important, because I think sometimes—and I think doctors mean well when they do this—they'll answer the questions that are asked in front of them, but they don't actually get to the underlying question. So I feel like if you give them a little bit of latitude to say, "Is there something I haven't thought to ask that I should be asking?" they'll sort of pull out other options, other tests, other things like that. And you mentioned the rule of three, and so this also goes to the fact that you should not show up to these appointments alone. And I realized that this is very much a luxury item. Not everyone can do this, but if you can bring a friend and have that friend listen and sort of hear the same thing you're hearing, what will happen is you will capture a huge amount more information when the two of you sit down after and debrief. And if somebody can take notes during the appointment, all the better.
Katie Fogarty 17:02: I love the question that, what questions haven't I asked that I should be asking? And I have such respect for doctors. My mom was a doctor. I know how hard people work. They're so kind and thoughtful and really trying to help people. But they're overworked and they're short on time. And so I think that's a really good way to open it up a little bit, to help you make sure you're not missing something important. So I really like that very much. One of the things I learned—and you mentioned it already—having ducks in a row is important. One very specific duck that everybody should have in a row is understanding short-term disability coverage, or STD. I learned from you that this is a policy that people can have outside of their workplace. So it's something that people can actually invest in separately or should be looking into. Or sometimes it is offered as part of your workplace, but it's not always something that everyone has, so people need to make sure that they are investigating this. Most of us, I think, in the working world understand long-term disability, but short-term disability was just sort of like an unknown for me. And I have a feeling I'm not alone. So can you just help people understand why this is important and what it is?
Rebecca Bloom 18:13: Yeah, so, so important. And I think you're absolutely right. Most people know about long-term disability. They may or may not have it, but it's not this completely secret kind of insurance. But in fact, short-term disability is hugely important. And the reason it's so important is that the moment you're diagnosed with something that's going to take you out of the workplace for a while, you may not have enough banked sick days or enough banked PTO to actually take the time off. So let's say you need to take four weeks off for a procedure, and you only have two weeks banked. What is going to happen is either you're going to go without pay, or you need short-term disability to kick in. And the reason this is so important is that even that short period of not having income can be really damaging financially for people. So what I urge people to do is to look at what their company offers in terms of short-term disability. And you may have to elect into it during the benefits cycle, which is, you know, once a year. And people should also know that there are policies you can buy on your own, like outside of your company. The issue with those is that they have to—you know, you have to buy them ahead of time, not when you're already sick, because then they won't cover you. So it's very much a preventative insurance type thing. So I really encourage everybody who's listening, next time you go through your benefits cycle, if you have benefits, really look into short-term disability and actually consider whether or not it's something you need. And even if you think you have enough banked sick days, it's not a bad idea to have it anyway, because you never know what's going to happen.
Katie Fogarty 19:54: Right, right. I think it's such good advice, and it's, you know, it's also—I'll just say when we're talking about all the things that you address in your book and the sort of how to prepare for getting sick, nobody wants to talk about this stuff. Nobody wants to think about it. It's like buying life insurance. It's like writing a will. It's not fun. Like, these are not the fun topics. But boy, if something happens, like, having this done is so important. I want to shift gears and talk a little bit about something that I thought was incredibly interesting because it was totally counterintuitive for me. In the book, you share a story of a woman who had a really serious medical diagnosis, and she decided to keep it quiet at work. And you write about how, yes, you can do this, but she would have been better served—and her name was Wendy—had she shared it with somebody in her life and asked for help. At the same time, if you're someone who's dealing with a diagnosis, you maybe don't feel comfortable sharing your status, which could even be your legal right. So I want to ask you to help us understand how to navigate this tension. When should you keep your diagnosis private at work? When does it make sense to share it? And how do you evaluate what's the right decision for you?
Rebecca Bloom 21:12: Yeah, so this is such a great question, and it's actually quite nuanced. And I will tell you, I have helped tons and tons of women figure this out, and it's very fact-specific. So the first thing I want to say is it's never a bad idea to tell somebody, but you should be strategic about who that person is. So Wendy's story, which you referenced, she didn't tell anybody at work. She was trying to keep it totally under wraps. And what ended up happening is she became really, really sick, and she was not able to do her job very well. And because nobody understood that she was actually going through a major health crisis, people assumed that she was just not competent anymore. And so there were some really bad outcomes from that. So had she told somebody—and it didn't have to be her direct supervisor, it could have been somebody in HR, somebody that she trusted—she would have been in a much better position. Now, here's the thing about the law. There are definitely protections for people who have serious medical conditions. The ADA, which is the Americans with Disabilities Act, protects people who need accommodations. The FMLA, which is the Family Medical Leave Act, protects people who need time off. But in order to access those protections, you often have to disclose something. You don't have to give all the details, but you do have to say, "I have a serious medical condition and I need this accommodation," or "I need this amount of time off." So there's a bit of a Catch-22 here where if you want the legal protections, you actually do have to share something. Now, you can share very little. You don't have to say, "I have cancer" or "I have this specific disease." You can just say, "I have a serious medical condition." But you do need to say something. And so my advice is always, if you're going through something, find somebody you trust at work and give them enough information so that they can help protect you. And that person might be an HR person, that person might be a trusted colleague, that person might be your boss. But you need somebody on the inside who knows what's going on, because otherwise you're really vulnerable. And I also want to say that there are some situations where it's actually not a good idea to tell your boss right away. If you think that your boss is not going to be supportive or that there's going to be retaliation, then you might want to go to HR first or you might want to consult with an employment lawyer first. So it's very, very fact-specific. But the overarching advice is: tell somebody.
Katie Fogarty 23:47: I think that's such good advice. And I think, too, you know, women tend to be people pleasers. We tend to want to be seen as competent and capable. And so sometimes we think if we share that we're struggling or that we're sick, that people will think less of us. But actually, I think the opposite is often true, that when you're vulnerable and you ask for help, people actually want to help you. And, you know, you can't get accommodations if people don't know that you need them. So I think that's really, really important advice. So on the theme of asking for help, which you keep coming back to—and I think it's so important—you have a whole chapter in the book on building your support team. And you mentioned earlier this idea of a chief of staff, which I love. Can you talk us through how to build that team and what roles people can play?
Rebecca Bloom 24:39: Yeah, so I think this is one of the most important chapters in the book, because if you do nothing else, building a good support team is going to make everything so much easier. So the first thing I want to say is that your support team is not your medical team. Your medical team is your doctors, your nurses, your physical therapists, whatever. Your support team is the people in your life who are going to help you get through this. And the first person you need is a chief of staff. And the chief of staff is the person who is going to be your project manager, essentially. This is the person who's going to help you figure out what needs to get done, who's going to do it, when it needs to get done. And this person should not be you. I mean, if you're sick, you should not be the person managing the project of your own illness. You should have somebody else doing that. And that person might be a spouse, it might be a best friend, it might be a sibling, it might be an adult child. But you need somebody who's organized, who's competent, who can handle stress, and who you trust. And that person is going to be invaluable. The next thing you need is sort of a tier of helpers who can do specific tasks. So you might have somebody who's the meal coordinator, somebody who's the childcare coordinator, somebody who's the errand runner, somebody who's the bill payer. You want to parcel out tasks so that no one person is overwhelmed and so that you have redundancy. Because if your one person who's doing everything gets sick or has to go out of town, then you're in trouble. So you want to have a bunch of people who can step in. And the last thing I'll say about this is that you need to be really specific with people about what you need. So when somebody says, "How can I help?" you can't just say, "Oh, I don't know, whatever." You need to say, "Can you bring me dinner on Tuesday?" or "Can you pick up my prescription?" or "Can you take my kids to soccer practice on Thursday?" Because people really do want to help, but they don't know how unless you tell them.
Katie Fogarty 26:32: I love that so much. And I think it's so true. I have found that when I've been specific with people about what I need, they're like, "Yes, absolutely, I can do that." And when I've been vague, people are like, "I don't really know what you want from me." So being specific is so important. And I also think that idea of parceling out tasks is really smart, because you're right, you don't want one person to be overwhelmed. And also, I think different people have different strengths. Like, some people are great at organizing meals. Some people are great at running errands. Some people are great at just sitting with you and keeping you company. So, you know, letting people do what they're good at, I think, is really smart.
Rebecca Bloom 27:09: Absolutely. And I also want to say that sometimes the most helpful thing somebody can do is nothing. Like, sometimes you just need somebody to sit with you and not talk and just be there. And that's okay, too.
Katie Fogarty 27:20: That's really beautiful. I love that. So, Rebecca, one of the things that I think is so important—and we touched on this a little bit earlier—is this idea of advocating for yourself with your medical team. And I think a lot of women, we're socialized to be polite, to not make waves, to not question authority. And I think that can be really detrimental when you're dealing with the medical system. So can you talk a little bit about how women can be better advocates for themselves and what that looks like in practice?
Rebecca Bloom 27:50: Yeah, so this is huge. And I think you're absolutely right that women are socialized to be deferential, to be polite, to not question authority. And that is really, really damaging in the medical context, because you need to be your own best advocate. And I'm not saying you have to be rude or aggressive, but you do need to ask questions. You do need to push back when something doesn't feel right. You do need to get second opinions. You do need to do your own research. And I think one of the biggest mistakes women make is they assume that the doctor knows best and that they should just do whatever the doctor says. And look, doctors are incredibly knowledgeable and they've gone through years and years of training, but they don't know everything. And they certainly don't know your body the way you know your body. So if something feels wrong, you need to speak up. And I think one of the ways to do this is to prepare for your appointments. So before you go into an appointment, write down your questions. Write down your symptoms. Write down anything that's been bothering you. Bring that list with you. And don't leave the appointment until all of your questions have been answered. And if you don't understand something, ask for clarification. And if you still don't understand, ask again. And don't feel bad about it, because this is your health. This is your body. You have a right to understand what's going on. And I also think it's really important to get second opinions. I mean, if you have a serious diagnosis, you should absolutely get a second opinion. And sometimes insurance will cover that, sometimes it won't. But even if you have to pay out of pocket, it's often worth it. Because what you'll find is that different doctors have different approaches, and you want to make sure that you're getting the best care for you.
Katie Fogarty 29:25: I love that advice so much. And I think, too, you know, writing things down is so important because, as you said earlier, when you're in that appointment, you're stressed, you're scared, you might not remember everything. So having it written down and then also, you know, bringing somebody with you who can help you remember what was said is so important. And I also love the idea of getting second opinions. I think sometimes people feel like, "Oh, if I get a second opinion, my doctor's going to be offended." And I think most good doctors actually encourage second opinions, right? Like, they want you to feel confident in your care. **Rebecca Bloom** 29:59 Absolutely. And if your doctor is offended that you want a second opinion, that's a red flag, and you should probably find a different doctor. Because a good doctor wants you to feel confident in your care and wants you to explore all your options.
Katie Fogarty 30:12: Yes, yes, I love that. Okay, so I want to shift gears a little bit and talk about something that I think is so important but often overlooked, which is the financial impact of illness. You know, we've talked a lot about the medical stuff and the workplace stuff, but the financial piece is huge. And I think a lot of people don't realize how expensive it can be to be sick, even if you have good insurance. So can you talk a little bit about the financial side of things and what people need to be thinking about?
Rebecca Bloom 30:43: Yeah, so this is probably one of the most stressful parts of dealing with a major illness, is the financial piece. And you're absolutely right. Even if you have good insurance, there are so many out-of-pocket costs. There are co-pays, there are deductibles, there are co-insurance, there are things that insurance just doesn't cover. And then there are all the indirect costs, like maybe you can't work as much, so you're losing income. Maybe you need somebody to help you at home, and you have to pay for that. Maybe you need to travel to get to a specialist, and you have to pay for that. So the costs can really add up. And I think one of the most important things people can do is to be proactive about this. So the first thing is to really understand your insurance. And I know we talked about this before, but it's worth repeating. You need to know what your deductible is, what your out-of-pocket maximum is, what's covered, what's not covered. And you need to know this before you get sick, if possible. Because once you're in the middle of a health crisis, it's really hard to figure this stuff out. The second thing is to ask about costs upfront. So before you have a procedure, before you start a treatment, ask what it's going to cost. And don't just assume that because something is covered by insurance, it's going to be affordable. Because you might have a huge co-pay or a huge co-insurance. So ask upfront. And if you can't afford it, ask if there are other options. Sometimes there are less expensive treatments that are just as effective. Sometimes there are generic medications instead of brand-name medications. Sometimes there are payment plans. So ask about all of that. And then the third thing is to keep really, really good records of all your medical expenses. Because a lot of this stuff is tax-deductible. And if you're spending a certain percentage of your income on medical expenses, you may be able to deduct that from your taxes. So keep all your receipts, keep all your bills, keep all your explanations of benefits from your insurance company. And then at the end of the year, you can add it all up and see if you can get a tax deduction. And that can actually make a big difference.
Katie Fogarty 32:50: That's such good advice. And I think, too, you know, people don't realize that there are resources out there to help with costs. There are patient assistance programs, there are charitable organizations, there are hospital financial assistance programs. So if you're struggling to pay for your care, there are often resources available. You just have to ask.
Rebecca Bloom 33:10: Absolutely. And I actually have a whole section in the book on this, because there are so many resources out there that people don't know about. And a lot of the pharmaceutical companies have patient assistance programs where if you can't afford your medication, they'll give it to you for free or at a reduced cost. And there are charitable organizations that help with specific diseases. And hospitals often have financial assistance programs where if you meet certain income requirements, they'll reduce your bill or even forgive it entirely. So there are a lot of resources out there, but you have to be proactive about finding them and applying for them.
Katie Fogarty 33:45: That's so important. And I think, you know, again, it goes back to not being afraid to ask for help and not being ashamed if you're struggling financially. Like, this stuff is expensive, and there are resources out there to help you. So definitely take advantage of them. Okay, so I want to ask you about something else that I think is really important, which is the emotional toll of illness. You know, we've been talking a lot about the practical stuff—the financial stuff, the workplace stuff, the medical stuff. But dealing with a serious illness is emotionally really, really hard. And I think sometimes people don't give themselves permission to feel their feelings or to get support for the emotional side of things. So can you talk a little bit about that?
Rebecca Bloom 34:28: Yeah, absolutely. And I think this is one of the most important things, because if you're not taking care of your mental and emotional health, it's going to be really hard to take care of your physical health. And I think one of the first things I want to say is that it's okay to not be okay. Like, if you're dealing with a serious illness, you're going to have bad days. You're going to have days where you're scared, you're going to have days where you're angry, you're going to have days where you're sad. And that's all completely normal and valid. And you don't have to put on a brave face for everybody. You're allowed to feel your feelings. And I think the second thing is that you should really consider getting some kind of emotional support, whether that's a therapist, whether that's a support group, whether that's a spiritual advisor, whatever works for you. Because having somebody to talk to who's not your spouse, who's not your best friend, who's not your mom, can be really, really helpful. Because sometimes you need to vent and you don't want to burden the people you love. Or sometimes you need professional guidance on how to cope with what you're going through. So I really encourage people to seek out that kind of support. And then the last thing I'll say is that it's really important to do things that bring you joy, even when you're sick. Like, even if you're going through chemo, even if you're recovering from surgery, find things that make you happy. Whether that's watching your favorite TV show, whether that's reading a good book, whether that's spending time with your dog, whatever it is, make sure you're doing things that bring you joy. Because that's going to help you get through this.
Katie Fogarty 36:06: I love that so much. And I think it's so true that we often feel like we have to be strong for everybody else, and we don't give ourselves permission to fall apart a little bit. And I think giving yourself that permission is so important. And I also love the idea of doing things that bring you joy. I think sometimes when we're sick, we feel like we're not allowed to enjoy life. And that's just not true. Like, you're still allowed to have fun. You're still allowed to laugh. You're still allowed to enjoy things. So I think that's really important. Okay, so I'm going to ask you a question that I ask a lot of my guests, which is—and we've sort of been dancing around this a little bit, but I want to make it really explicit—if there's one thing that you wish every woman knew about dealing with illness, what would it be? Like, what's the one piece of advice that you're like, "I wish I could just shout this from the rooftops and make sure everybody knows this"?
Katie Fogarty 39:15: Right? You gotta be specific. This is true of any kind of ask. You have to make it easy for people to help you. And I think the job thing is such a great example, because people will say, like, "Can I have some of your time?" And they don't even tell you why, which is a mistake. One of the themes of this show is to become a smarter patient. And you have to know what's out there, what the latest health science around whatever it is is impacting you. You have to understand that—I've had a million doctors on this show that say suffering should not be inevitable. So if you're struggling with something, help is out there. You get people to help you, and you make it easy for the doctors to do so. So I love that advice. In all these conversations, the thousands of conversations that you had, like, have you ever thought to yourself, like, "I wish I could just wave a magic wand and make this happen for people, like, I wish everyone were doing this one thing"? Like, I can't stop talking to people about vaginal estrogen, and so I'm obviously very fun at parties, because people are like, "Please stop talking about vaginal estrogen." But I sort of feel like, if this were something that was as standard as flossing, there'd be a lot less suffering for people, because they wouldn't have issues. So is there something that you've come across where you're like, "I really so wish that everyone were doing this one or two things"?
Rebecca Bloom 40:29: Yeah, and it's actually pretty simple. There's a lot of technical stuff in my book, as you know, and a lot of things that sort of are—I'd file it under "I wish I didn't have to know this, but I'm glad I know it so I can help other people with it," right? But the thing I wish most is that people would consider all the ways that they've shown up for the people in their lives, and be willing to be really, what amounts to being generous enough to be able to allow those people to help them in turn. Because really, if we link arms together, even though the system was absolutely not built for women, we have a lot of what we need to make women's health journeys better.
Katie Fogarty 41:22: I love that. I love that. I love that. I love it. I think that, honestly, getting to midlife allows us to be more open and vulnerable. And women are incredible helpers. You think about we're always offering help to one another, and sometimes we're more reluctant to take it on ourselves. So it's so important to just accept the generosity that people want to shower on you. And I love that encouragement. I think it's really smart, and we could apply that to all areas of our life, not just our health. So my last question, Rebecca, is, like, what do you want somebody to take out of this book? That's like your big picture piece of advice. When a reader goes through this book, what do you hope they'll think, feel, do, and be after they close the final page?
Rebecca Bloom 42:05: I hope that they will feel really empowered. You mentioned the word agency earlier. I hope they will understand that they have so many levers in their own lives that they can pull to make all of this so much better. No woman has to go on a health journey alone.
Katie Fogarty 42:25: Amen. Amen to that. When Women Get Sick is a good companion. I think listening to this conversation has been terrific and inspiring to me and hopefully to listeners. And I would also say, share this with the women in your life, because the more you know, the more you know. And we need to look out for one another. So get the word out about this book as a resource. Pass this episode along to the people in your life, because I know it's going to make a difference for someone. Rebecca, thank you so much for being with me today for this really important conversation. I feel smarter. Thank you.
Rebecca Bloom 42:58: Thank you so much, Katie. You're already really smart.
Katie Fogarty 43:03: This wraps A Certain Age, a show for women who are aging without apology. Thanks for sticking around for this super smart conversation. Rebecca has created a must-read guide to help us navigate the tough stuff for ourselves, for our friends, for our family members. Getting to midlife means sometimes you need to handle stuff you don't want to handle, but when we avail ourselves of the resources and the smarts of other women, other experts, we can get through what we need to get through. So thanks for sticking around for the show. Share this with friends who need this information. Add this book to cart. Put it on your bookshelf so you can pull it off if and when you need it. I appreciate your hanging around to the end of the show. I appreciate you being with me every single week. I appreciate your Apple Podcasts and Spotify reviews. I see them and appreciate them. I believe this episode deserves all the stars. Special thanks to Michael Mancini for composing and producing our theme music. See you next time. And until then, age boldly, beauties.