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in Health &middot September 15, 2017

The Deadly Consequences of Incorrect Healthcare Reform

As you most likely know, the debates around healthcare laws and possible replacements for the current plan is near and dear to my heart. Through my own health situation, I have learned extensively what the ACA does and doesn’t allow, and where the failings are. I’ve talked abut how the ACA is valuable to me and my situation, and I’ve mentioned extensively on social media how certain protections provided by the ACA quite literally keep people alive. In my case, not receiving treatment can lead to my death, but in an incredibly lengthy process that could take years (the more pressing issue for me is being a semi-functional human being). For example, a 2015 study found that RA patients have a significantly higher risk of death, especially from cardiovascular and respiratory complications. Not receiving treatment will lead to my immune system attacking more and more organ systems; the last time I went off of my treatment (to try a new one), I developed endometriosis. The next time, I could develop heart disease.

One of those people fighting a much more direct possibility of death without the protections of the ACA is my friend Olivia Cline. We met through our graduate program and bonded over our chronic illness struggles, especially since so many of our peers did not understand what the chronic illness life is like and how it affected our education. She has written this post about how her life is literally dependent on the ACA protections, and I cannot emphasize enough how important it is that you read this.

Over the last 9 months, there have been several attempts to reform or repeal the Affordable Care Act. But if that is done incorrectly, it can have literally deadly consequences. Chronic illness patients as a whole massively benefit from the ACA, and some of those are people who will die without certain provisions remaining. Not next year, not in ten years, but within months.

I had big plans for Labor Day Weekend this year – UNC Chapel Hill football game on Saturday, taking my dogs to the dog park on Sunday, hiking the Blue Ridge Parkway on Monday.

Instead, I spent Saturday and Sunday in the throes of one of the worst vomiting spells I’ve ever had, featuring a trip to urgent care on Saturday afternoon and the emergency room on Sunday morning because the same anti-emetics they give to chemo patients weren’t touching it and I was so dehydrated I was bleeding from the nose every time I threw up, and Monday getting liter after liter of IV fluids to make up for everything I’d lost.

This isn’t an atypical weekend for me, either. I have Ehlers Danlos Syndrome (EDS), a multi-systemic connective tissue disorder that affects my joints, cardiovascular system, bladder, and digestive system, and I’m sick so much that the local emergency department, pharmacy, and infusion centers know me by sight. I’m 24, but by my “current medications” list, you’d think I was 80. Within the last year alone, I’ve had nine surgeries. I have a central venous catheter (a type of permanent IV) in my chest, and I need two liters of IV fluids a day to stay conscious – and even that’s not a guarantee.

I also have a feeding tube – and this is where my life gets really complicated. I’m on my second type of tube. The first one failed two months ago, because my stomach rejects anything I put in it. This one, which bypasses my stomach, is failing for similar reasons – my intestines can’t handle anything close to a formula rate that would give me enough calories to keep me alive.

Effectively, my body is starving itself to death.

We have one more option after this, which is called Total Parenteral Nutrition (TPN) – basically, nutrition straight into my veins – but TPN thrashes your liver, usually causing patients to need a transplant within ten years or so, and putting me on TPN means I might be looking at planning my own funeral before I turn 35.

With highly expensive treatment being one of the only options for many rare disease patients, reforming certain elements of the ADA can lead to either spending all of their money on healthcare or dying from their disease.

And to top all that off, I opened a Twitter news alert today, with a pit of dread in my stomach, to discover yet another threat to my health – this time from Congress.

As of now, I’m blessed to be insured. But I cost tens of thousands of dollars a year – at artificially inflated healthcare prices – to stay alive. If I move to TPN, that alone will cost a thousand dollars per day. It would be impossible for anyone, even my relatively well-off family, to pay for my healthcare at that rate.

If the Affordable Care Act is repealed, patients who cost insurers the amount that I do will be the first to suffer – there are countless reports demonstrating as much. Healthcare for the sickest relies on funding from coverage for the healthy, and like all the others, the latest iteration of GOP healthcare legislation repeals personal and employer mandate, draining a significant chunk of funding from the insurance market.

Already, examples abound of insurance companies refusing to cover certain treatments because they’re “not medically necessary” or “not the accepted treatment for that condition.” Unfortunately, a lot of treatment for rare patients like me is experimental – and expensive. Even if we don’t lose coverage entirely, the covered options available to patients like me will shrink exponentially.

A major part of the anti-Obamacare rhetoric has shaped itself around Paul Ryan dubbing Obamacare a “nightmare” back in March. For me, though, a far greater nightmare is not just fighting to find a solution that will keep me from starving, but fighting to do it before a bunch of men in Washington DC cut off my access to healthcare.

Personally, I’d rather fight my body.

Olivia Cline is an adjunct professor and medical publisher trying to make North Carolina better one classroom at a time. When she’s not in the classroom (or in the hospital), you can find her in the mountains, taking too many pictures of her dogs, or yelling about sports on the Internet. (Go Heels!) You can find Olivia on Instagram (and her dogs’ amazing Instagram) and Twitter.

Like this post? Share it by clicking on one of the buttons to the left. You can also check out these posts:

What’s the Value of the Affordable Care Act?, Why You Should Contact Your Representatives & How To Do It, How To Become an Advocate for Patients, Examples of Ableist Language in Everyday Life

Kate Mitchell

Kate Mitchell is a blogger, chronic illness patient, and advocate who helps people understand chronic illness and helps chronic illness patients live their best lives.

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Dos and don'ts for when someone in your life is di Dos and don'ts for when someone in your life is diagnosed with autoimmune arthritis! What are some that you would add?⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: "So someone you know was diagnosed with Autoimmune Arthritis". Under the Do column (indicated with a green checkmark) is:⁣
"As how they feel about it⁣
Offer specific ways to help⁣
Treat them normally⁣
Ask follow-up questions⁣
Wear a mask around them when sick."⁣
Under the don't don't column (indicated with an x in a red circle) is:⁣
"Say “At least it’s not xyz!”⁣
Say that and not follow through⁣
Assume nothing about their lives has changed⁣
Conflate autoimmune arthritis with osteoarthritis⁣
Pass your cold to an immunosuppressed person".⁣
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#AutoimmuneDisease #RheumatoidArthritis #PsoriaticArthritis #AnkylosingSpondylitis #JuvenileArthritis
Weekj 26 of 2026 Weekly Scenes of a summer week Weekj 26 of 2026 Weekly 

Scenes of a summer week in Maine! So glad I work from home, which means I can work from my real home (Maine, if that wasn’t clear)

1️⃣ Lots of Harley time
2️⃣ Working from home means saving my PTO for fun things!
3️⃣ Lots of duck families (📸 my dad)
4️⃣ What a lot of my days look like - Harley and my current project (needlepoint). And, yes, I’m still in a cast.
5️⃣ Learned how to play Mahjong, which my parents love
6️⃣ Lake views on the 4th

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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣⁣⁣⁣

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IDs:
1️⃣ Harley the golden retriever on a deck as seen through some plants
2️⃣ Kate takes a selfie
3️⃣ A duck with little ducklings following on a lake
4️⃣ Harley coming up to Kate. Her legs are out on an ottoman, 1 foot in a walking cast, and an in-progress needlepoint project
5️⃣ Looking down at a Mahjong table with the game set up
6️⃣ A kayak on the shore of a lake 

#MaineTheWay #MaineSummer #Needlepoint #MaineLife
Living with chronic pain is really hard. You’re wi Living with chronic pain is really hard. You’re winning every day you’re still here.⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: The background image is a lake at sunset. Text reads what's above the first square and also "katethealmostgreat".⁣
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#ChronicIllness #ChronicPain #RheumatoidArthritis #Fibromyalgia #Endometriosis
I've been spending a fair amount of time at my foo I've been spending a fair amount of time at my foot surgeon's office this year, and boy has it been messing with my head. ⁣
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I spent a lot of time from 2001-2010 dealing with my left foot. Long story short, it took until this foot surgeon saw me in 2010 after fixing this foot for me to be diagnosed with rheumatoid arthritis. But I spent those 9 years going from doctor to doctor, having surgery after surgery, trying to figure out what was causing my pain and to fix it. ⁣
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Was it the tarsal coalition? Did I have another chronic health issue? Etc. ⁣
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I spent from age 10 to 19 unsure what exactly was wrong with me and in huge amounts of pain. We thought we figured it out, and then something else happened. ⁣
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We know exactly what is wrong with this foot this time around: in 2024, I got 3 stress fractures, and no one put me in a boot. They almost fully healed before breaking in 2025, and then the same thing happened in 2026. ⁣
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This is a different part of the foot than I used to deal with, but any problems with my feet and especially my left foot messes with me. While this doctor eventually fixed the problems and even got me diagnosed with RA, every time I go back to his office, I have to fight not to become 17 again. ⁣
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PTSD is a bitch.⁣
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(PS - if you want to know why I'm going back to this guy when it messes with me, it's because I don't trust anyone else to fix my foot.)⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: Kate takes a selfie in a doctor's office. ⁣
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#PTSDAwareness #ChronicallyIll #TarsalCoalition #RheumatoidArthritis #Osteoporosis
Week 25 of #2026Weekly Happy to be in Maine for Week 25 of #2026Weekly 

Happy to be in Maine for a few weeks! I didn’t get up to a lot, so another week of very few pictures

1️⃣ IVIG 
2️⃣ Lots of beautiful birds have been coming to my mom’s bird feeder!

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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣⁣⁣⁣

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IDs: 
1️⃣ Looking at Kate’s lap. Tubes are coming out from under her shirt and there’s a Kindle
2️⃣ Birds arriving at a bird feeder as seen through a window

#ChronicallyIll #InvisibleIllness #ChronicPain #IVIG
What do you have to do every day for your chronic What do you have to do every day for your chronic illnesses? ⁣
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For context, I have rheumatoid arthritis, fibromyalgia, endometriosis, POTS, heart disease, osteoporosis, and more. ⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: ⁣
Things I Do Every Day for My Chronic Illnesses⁣
Take pills at least 4 times a day⁣
Don’t eat gluten, dairy, corn, soy, or eggs⁣
Sleep 7+ hours a night⁣
Consume 80-100 grams of protein, 120 mg of calcium, 5-10 grams of sodium⁣
Wear a mask whenever I leave the house⁣
Do pilates 4+ days a week⁣
Work from home⁣
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#ChronicallyIll #InvisibleIllness #RheumatoidArthritis #Fibromyalgia
Filmed this back in April (hence the sweater) but Filmed this back in April (hence the sweater) but it applies to whenever I have appointments! 

Video: Kate talks to the camera while holding a purse. She holds up individual items mentioned in the video before putting them in the bag. There are captions. 

#ChronicallyIll #RheumatoidArthritis #Osteoporosis #ChronicPain
There are a lot of medical advancements that I'm g There are a lot of medical advancements that I'm grateful for, but one of them is the ability to do IVIG at home. ⁣
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I'm on IVIG - or, in my case, subcutaneous immunoglobulin replacement therapy - because I have to kill the better part of my immune system. There are, in fact, some parts of my immune system that don't attack me, which is why we add them back in. This helps reduce my chance of serious infection and also made my rheumatologist feel comfortable enough to increase my Rituxan dose. ⁣
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This is a weekly treatment that I do, but it's so much better that I can do it at home than going into the hospital. It takes around 2.5 hours from taking my pre-meds to tossing my needles into a Sharps container. While it's another thing that I have to do, because I do it at home, I don't have to risk exposure to infections at the hospital or deal with Boston traffic, which would add another hour to the process. ⁣
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I can finish my treatment and then go about my day, which I'm very grateful for.⁣
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⬛⁣⁣⁣⁣⁣⁣⁣⁣⁣
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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣
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ID: A Kindle on Kate's legs. There are tubes for an infusion coming out of her shirt.⁣
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#IVIG #ChronicallyIll #RheumatoidArthritis #Autoimmune #AutoimmuneDisease
Weeks 23 and 24 of 2026 Weekly! The last two wee Weeks 23 and 24 of 2026 Weekly! 

The last two weeks were prepping for my infusion, having/recovering from my infusion, and getting caught up after. This meant things were very busy but also I don’t have a lot to show for them. 

1️⃣ New glasses! I really like having multiple pairs so I can switch them as I want.
2️⃣ One of my current projects. I got this standing hoop for my birthday and I’m working on an alphabet (uppercase and lower, although I’m still working on the lower) with extra floss.
3️⃣ Infusion time! I got my higher dose so hopefully my symptoms improve a lot in the upcoming weeks🤞🏻

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I’m Kate, a chronic illness patient and advocate sharing what my life is like with 10+ chronic illnesses. Follow me for more and check out my blog at katethealmostgreat.com⁣⁣.⁣⁣

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IDs: 
1️⃣ Kate takes a selfie. Her new glasses are thin silver circles
2️⃣ An in-progress cross-stitched alphabet in a special hoop stand that Kate is sitting on.
3️⃣ Kate takes a selfie in an infusion chair.

#ChronicallyIll #RheumatoidArthritis #AutoimmuneDisease #CrossStitcher
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