Again, Shaun Purley can't sleep.
On this night she's worried about her doctor's appointment at 9 the next morning.
She frets because she can't afford to pay for it, or for the insulin and supplies she needs for treatment of her Type 1 diabetes.
Should she call first thing in the morning and tell them she can't pay? That way she'd be spared the drive to the office if they refuse to treat her. Should she go and tell them in person, just in case they'll help her anyway?
"The victory of the day was that the doctor saw me and I left with medicine, needles, and insulin pens," Ms. Purley said later that morning at her modest three-bedroom home just off the Dorr Street border of the University of Toledo.
Such is life for the 42-year-old divorced single mom who is one of many area residents struggling to get by in a recession that has sliced across all strata of society and into all demographic cubbyholes.
Occasional victories help, such as the generosity of Ms. Purley's doctor and office staff. But she recalled something her mother taught her: "Every victory is not celebratory."
"You win battles that hurt you as much as if you had lost them," she explained. "They helped me," she said of the doctor and staff. But "my pain is that I can't pay them and I want to."
Many others feel that pain. The 2008 Ohio Family Health Survey found the rate of 18-to-64-year-olds in Lucas County who don't have health insurance rose from 13 percent in 2006 to 19.5 percent in 2008 - second only in the state to Summit County's 19.8 percent, said Jan Ruma, executive director of Toledo-Lucas County CareNet. Care Net (toledocarenet.org) was established by former Toledo mayor Jack Ford in 2003 to address the growing number of uninsured adults in Lucas County.
Ms. Purley described her current financial condition as "tight. It's very uncomfortable."
A 1984 graduate of Rossford High School and a 1988 graduate of Ashland University in Ashland, Ohio, with a degree in social work, Ms. Purley said she moved into the human resources field after burning out in a job at Lucas County Children Services. In 2003, she was laid off from a full-time job at TolTest Inc. of Toledo when the firm split into two companies, "and I've not had a decent job since."
Ms. Purley now has a part-time, $12.50-an-hour position as a human resources representative for Homewatch CareGivers. She used to get 30 hours a week; her hours were cut to 15 in January and have climbed back up to 24 a week.
She stretches her paycheck to cover the house payment, utilities, and expenses for herself and her sons Roosevelt, 20, a 2006 graduate of Bowsher High School who works at McDonald's, and Jordan, 9, a fourth-grader at McKinley School who also has Type 1 diabetes.
"I had to file bankruptcy last year to keep the house," Ms. Purley said. "There was no way to make ends meet - they couldn't even wave to each other."
She said she likes her job, but continues to look for something else.
"I need health insurance and 40 hours of work at a decent rate of pay," Ms. Purley said. "I don't want anything for free. I want to be able to pay my bills."
Meantime, she gets by, in part, through the same resourcefulness that she tapped to generate $40,000 in financial aid for college tuition.
"There are so many resources in Toledo," Ms. Purley observed. It's not easy to admit you need them, though. "You have to swallow the big, nasty pill and say, 'I can't pay for this.' "
She keeps a steely grip on expenses. Roosevelt is forbidden to plug in a small refrigerator in his bedroom. Lights are turned off in rooms that aren't occupied. The air-conditioning unit that cools the first floor hasn't been plugged in for two summers. Ms. Purley shops for clothing at resale stores. They don't go to movies anymore.
She has deferred some home improvements that aren't urgent, as well as some things that are - most worrisome of those is the mammogram that's two years overdue.
"I'm very worried because breast cancer runs in our family like a river," Ms. Purley said.
Despite the family's precarious financial state, "I don't say we are poor," she asserted.
"My lights are on, the heat is on, I've got a home Being grateful for the little things is what gets you to the big things.
"We figure it out. We make it work."
TOMORROW: A farm struggles with foreclosure and bankruptcy.
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