For the afflicted, a source of hope

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When Rosalie Cretser of Ashland was diagnosed with cervical cancer she relied on the Ashland Community Health Center’s “Every Woman Can Have A Medical Home” program.Jim Craven

November 09, 2008

By Sanne Specht

Mail Tribune

When Rosalie Cretser moved from Arizona to Ashland to help her father battle cancer, little did she expect to be diagnosed with the life-threatening disease herself.

The successful career woman already had suffered a series of misfortunes that left her out of work and without health insurance.

"Then I got that phone call," said Cretser, remembering the moment last March when she learned she had cervical cancer.

Four years ago, Cretser, 46, was a corporate director of sales and marketing at an international software company. She made $80,000 a year and owned a lovely home on a golf course. Then, while on a business trip to Chicago, a flu-ridden Cretser fainted — and fell down two flights of escalator stairs. The resulting head injury placed the single mother of three on workers' compensation for six months.

"I suffered a very serious concussion. I was seeing neurologists a lot. I had to learn to re-speak. I still have problems," Cretser said, shaking her head and looking down at her pale hands.

The accident was the first in a series of injuries, illnesses and financial setbacks that would leave the former executive struggling to make sense of a world turned upside down.

Cretser's emotions range from self-deprecating humor to tearful frustration when discussing her trials. But a grateful smile illuminates her face when she speaks about the help she received through Ashland Community Health Center's "Every Woman Can Have A Medical Home" program.

Not only did she get an early diagnosis of her cancer, but through the center was able to qualify for financial assistance for her surgery and treatment, she said.

Community Health Centers in Ashland, Medford and White City offer eligible women free health exams and referrals for a free mammogram. The goal of the program is to save lives through the early diagnosis and treatment of potential health risks, especially cancer, by removing barriers to care for women who are uninsured or under-insured, said Peg Crowley, executive director of Community Health Center, who is also a registered nurse with a master's degree in public health.

Industry indicators make it likely that more formerly financially successful women, such as Cretser, will face serious health crises on the heels of devastating career downturns. For women already living paycheck to paycheck, the tipping point already may be here, said Karen Elliott, resource development specialist for Community Health Center.

National relief, when and if it finally it comes, may be too little or too late for many of Jackson County's 70,000 uninsured or under-insured men, women and children if they already are facing health crises, Crowley said.

"The need is increasing every day," Crowley said.

"This is why we want them to know the Jackson County Community Health Centers — and the 'Every Woman Can Have a Medical Home' program," Elliott said. "We want to eliminate cost as a barrier for limited-income women to obtain these exams, because they can save lives."

After her accident, Cretser struggled to pay her mounting medical expenses, as well as her other monthly financial obligations, with the payments she was receiving through workers' compensation. Inevitably, Cretser began falling behind in her house payments, she said.

"But the bank was understanding. At first, anyway," Cretser said.

Six months later, Cretser returned to work, she said. Then, during a conference call, Cretser experienced a "horrible headache," she recalled.

"I thought I had a migraine. I'd never had a migraine," she said.

Cretser's "headache" was caused by the rupturing of a non-cancerous tumor behind her eye. The new health crisis placed her on disability where she received a reduced salary during her four-month recovery, she said. Cretser fell even further behind in her house payments.

Cretser returned to work in September, only to be permanently laid off in November, she said.

"I was scared. I was angry," Cretser said.

Then came the discovery that her father had cancer. Cretser decided to sell her Arizona home and use what little equity she had left to move to Ashland so she could be closer to her elderly parents. She wanted to help her mother care for her ailing father.

Suffering from what she believed was a persistent bladder infection, Cretser's trip to a local emergency room turned into a follow-up visit at the Ashland Community Health Center.

The job of informing Cretser about her latest bad news fell to Kathryn Stringer, family nurse practitioner at the Ashland center.

"I had to tell her (the Pap smear) was abnormal and that she likely had cancer. It was very difficult for her," Stringer said.

It was another devastating physical, emotional and financial blow. But this time Cretser had no job, no insurance — and no way to pay for expensive medical treatment. And she didn't want to burden her parents, Cretser said.

"I wanted to help care for my dad. I just didn't expect they'd be caring for me," she said, choking back tears.

Because Cretseralready was enrolled with the center's "Every Woman Can Have a Medical Home" program, she qualified for the Oregon Breast and Cervical Cancer program, which in turn qualified her for a special Oregon Medicaid program that covered the costs of her treatment and surgery, said Elliott.

"We would encourage women of any age who do not have a medical home and are symptomatic to make an appointment with Community Health Center," Elliott said.

Women traditionally put themselves last, particularly when money is tight and there are others to care for, said Mavis Cloutier, a member of Soroptimist International of Ashland.

"We'll push our health issues to the back. It's just how women are. Particularly for medical screens like Pap exams and mammograms," Cloutier said.

When it comes to cancer, a delayed diagnosis can be deadly. And it is not only cancer that can kill. So can high blood pressure, diabetes and other illnesses. The woman's exam includes other areas besides cancer screening, said Stringer.

"We are treating the whole woman," she said.

Proactive health care saves money in the long term. The dollar difference between funding preventive care versus paying for treatment is $1 to $4 and climbing, Cloutier said.

"(Soroptimists) believe strongly in prevention," Cloutier said.

Cretser never thought she'd be someone whose life would depend upon the services provided by a community clinic. But she is willing to share her story to educate other women about a valuable community resource, Cretser said.

"I hope that other women know about this program — because I had no clue. And I cannot say enough good things about this program and these people," said Cretser.

Cretser is currently working part time at a retail shop in Ashland. Relieved her father has recovered from his ordeal, she still struggles with the aftermath of her own cancer battle. She is eager to make the transition from "care receiver to care giver," Cretser said.

Cretser has no interest in returning to corporate life. She's seeking a new career, perhaps in the medical field helping other women who will face what she has endured, Cretser said.

"I want to give without taking for awhile," Cretser said.

"Don't get me wrong. I'm not saying, 'Woe is me,' because I feel very blessed. But you can't go through something like this without wanting to give back."

Reach reporter Sanne Specht at 776-4497 or e-mail sspecht@mailtribune.com.

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