They are all around you - you probably work with a few. They are modest. They endure. Sometimes, you get a chance to get a glimpse of what their view of things is.
Last month our friend Chuck had an experience worth your time. Thank him for sharing his story so others may know what he and thousands of others deal with because we asked them to.
I have a pinched nerve in my thoracic vertebrae, part of the degenerative disk disease I apparently have (something to do with extreme trauma to the spine, like from landing on your head wearing 70 lbs of gear after sailing through the air.) The nerve cluster in T4,5, and 6 is affected. This nerve cluster sends pain signals that start at the spine just below the shoulder blades and radiate around the chest (the right side in my case) and terminate with a stabbing, sharp pain sensation in the chest cavity. This has been going on for almost a year, and I was being treated for it when I left Fort Leavenworth. Lately, it has been acting up, giving me mild to moderate pain; however when you know the source of the pain it makes it easier to ignore/deal with it. The biggest effect it was having on me was inability to sleep, other than from 12 AM-3AM, plus adding to my usual irritability.What follows is a 03:50 to ~08:00 the next day timeline.
It will make you wince, it will make you cheer, it will make you scream in anger. It might make you cry, and thats OK.
Read it all.
Chuck; Fullbore.
19 comments:
I absolutely understand what Chuck is going through. Been there numerous times with a similar injury. Giod Bless him for his stubborn ways. :)
Can give you the same tale at the VA in Vermont. Fourteen months of shooting pains from three spinal fractures and two ruptured discs (little sleep, limited mobility, unable to run), only to be sent to a nearby civilian hospital that they have an affiliation with. Steroid injections there bring immediate and lasting relief. Here's the fun part:
"Customer Service" informs me after I get a BILL for a service-related injury that the doctor who referred me didn't "get it approved" and I owe $4,000. Apparently "customer service" to the VA means telling the customer all those things anyone in the hospital is unwilling to do on the customer's behalf.
When I asked about any grievance procedure? "Write your Congressman". Both the VA here and my Congressman will regret that advice.
Sad part is, the above is not unique, rather is fairly common. And by no means the worst of them.
Oof, been there, big time (L3 to SC1 and C3 to C5). Started with a 7/10 not long after 9/11 and ended on the surgical table Dec 05 (3rd operation). The good news is without surgery, the pain will eventually stop -- the bad news is when the pain stops, so does the ability of your leg, arm, whatever to function.
Took a new neuro-surgeon at NMMC Bethesda to nail the problem, & perform the surgery using new technology (gained from his residency at mayo clinic) to effect the change. He is my hero -- doubly so with his back-to-back overseas deployments to IQ and time spent post-Katrina in the Gulf. Said that his goal in life was to "fix broken Marines and Sailors, period."
w/r, SJS
That's why they call it "Crippler." Staff there are totally incompetent and don't care at all. No accountability whatsoever. If you're serious about going to a real (non-VA) hospital, try Queen's downtown.
GM (government medicine) SOP.
Complete sympathy with the don't read the chart, walk in and wing it... sawbones problem. Ditto with the "pain is not the problem, it's a symptom, so don't relieve it until we figure out the problem, take his history (again)" SOP.
A good Physician is a pearl beyond price. There will be fewer of them in the future.
Me too. I have 2 fused vertebra at the I4/L5 level, and I've been trying for over a week to be seen at the local VA hospital with what I suspect is a herniated disc just below them.
And I also know all too well the frustrations of having to wade through the VA system. Don't get me wrong, I am greatful to have them there, and when I've been worked on and recovering, the staff has been wonderful.
It's the beauracrcy that's doning me in.
My similar story is a lot lower in magnitude.
I used to get ear infections all the time. Went to the base clinic at Mayport with screaming pain in my left ear one time, got there at about 1500 or so. Waited, waited waited. They never got around to seeing me before they closed early for the day, told me that I could either come back in the morning or drive to the hospital at NAS Jacksonville. Well, that's about a 45 mile drive, and since I was leaving more or less at the start of rush hour it took forever to get there, then another 2 1/2 hours waiting there ... anyway, by the time I got seen, the doctor said that another half hour or so and my eardrum would have ruptured. He loaded me up with antibiotics and gave me Vicodin. Only time I ever saw narcotics at a Naval medical facility.
Not in any way on a level of magnitude with Chuck's issue, or some of the other guys here ... but it still pissed me off.
Precisely. With fewer financial rewards, fewer people will want to be doctors (since it's far from easy to become one), so there will be more stress on an already over-stressed system. Why don't they subsidize medical school instead of all this insurance crap?
Sigh. It did make me cry. I'd been at that crying and embarassed point myself (though the intensity of my pain/incapacity was far lower) as nothing in my life had felt as embarassing as that failure, except the fact that I was crying about the failure, which was more embarassing and caused more crying. I'd thought it was just that I couldn't hack it, but it was Lyme's disease and after diagnosis, they cured it.
But I was told that everyone should have access to free medical care, it will be great, just like the VA!
/sarc off
Having spent way too much time dealing with docs and hospitals for mom, dad, sister, niece, great aunt, grandfather, grandmother, well you get the picture (touch wood, my time there hasn't come - yet), I finally realized the file is _only_ for CYA purposes. NO ONE looks at it, except a paralegal in connection with a med mal lawsuit (which isn't generally allowed against the government). That's why you have to tell every single human being in the hospital what meds you are taking, what you are allergic to, and why you are there, even if you told someone else on the same floor two minutes ago. And always ask for (and keep, and bring along - it does you no good back at the house) a copy of the doc's file notes, lab results, x-rays, etc. If you're lucky it will be in the file (that no one looks at), but about half the time you won't be lucky and will be glad you have your copy.
About 5 years ago, I took the step of using my wordpad application and producing a sheet of paper that lists all my meds, my name, SSN, addy, next-of-kin, allergies, and everything else the doctor might need. I keep a copy folded up in my wallet, another in my backpack, etc.
Came in handy a few months ago when I gad to go to the ER with chest pains. Gave the nurse the sheet and she daned near kissed me. Saved me having to repeat everything, because she made a copy of it and stuck it in the file.
It took me maybe 20 minutes to gin it up and it's been worth every penny since.
FWIW, I also went back to wearing my dog tags whenever I travel. That info can at least get someone started on helping me were I unable to respond to them, and alert the responders to chreck with the military for my records, etc.
V/R
"back-to-back".. not that is a pun amongst puns!
Look at it from the Doctors perch....
Once accepted at an approved Med School and past the first semester, (don't even bother to apply without a 4.0 double major (preferrably Bio and Chem) and perfect MCAT scores... unless you got pull from somewhere, where is another post...), the student loans are totally available, indeed pushed. After Med School, Internship, & Residency you have a nice loan for a quarter to a half million bucks on a 30 year note. So you go find a job, buy a house and a minivan and start a family. More debt. Welcome to your 30's, rookie.
OK for Cardiologists and Brain Surgeons, they get big bucks quick. Family Practice, Emergency Med and Pediatrician...you have not much disposable income after servicing the debt, say about like a Bachelor of Sci Nursing on a surgical team for the Brain Surgeon. After a decade you start your own practice - if you can find a bank (this year, you can't), then you keep about what an ICU RN (with no BS) does, with luck. Or you buy in (more debt) as a partner, or be a "hospitalist". For the "hospitalist" guy in the ER....the pay is good, the hours regular, you are paying down debt and as long as your "productivity" is good life is groovy.
OBTW - Good "productivity" is one patient every 5 minutes. When they cut the Tricare rate and the hospital still sees Tricare patients, make that one patient every 3 1/2 minutes. Which is why Mayo dropped Tricare last year, to protect their brand, errr, good name. Because you can do it good, do it fast, or do it cheap. Pick any two. THIS is BEFORE Obamacare.
Which might be better. Don't bet your life, though. Oh, that's right, Congress already did.
The AMA? Academics and Administrators run it, the folks who touch patients, not so much.
Another fine mess....
Bad disc, like me.
Looks like the pack,
All have a bad back.
Is that why the winds and waves are so restless?
Yes, yes, yes. But bring a handful of copies. The doc's office will need one, the hospital will need another, etc. (but enough about my day yesterday).
And the same applies to those health powers, too!
Guest, +1. And if the Doc decides to follow the "family business" and serve in the military until their late 30's or later their "productive" years are even fewer, especially if they're out in the rural areas where, despite Congress's wise decision on Medicare and other reimbursements, it costs more to treat patients than urban areas and doc's make, gross, about 50% less than their big city cousins. But I digress, what this guy went through drove SWMBO (see above) nuts. But as an Army vet, sadly not surprised. When she told the Green Machine she was leaving they tried to entice her to stay by offering her 4 years at TAMC. "No $%^&ing way" was her reply.
I notice on this guy's blog he has received the implanted system and the relief is really signifigant and he's scheduled for, surprise, gall bladder surgery soon. Seems like his gall bladder was indeed acting up.
Re-reading that it sounds like I am anti-doctor, which is far from the case. The big reason no one reads the file is there isn't time - how can anyone go through 4 inches of paper (or the electronic version of it) and still keep to a 5 minute per patient schedule. Sadly, these days everyone gets paid for doing procedures, so no one gets paid to sit down and do analysis of, say, a 4 year trend of blood work results.
My mother is going thru similar experience, with the back pains going worse every year, and knee damaged in accident few years ago. She says stoically that her body has run of its warranty :) . I am quite vulnerable to pain mysef, so I admire those that brave it even more.
Ahh Military medicine. You get what you pay for. I like the picture of him swinging a sledge hammer, flexing his back. It contrasts nicely with the story.
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