Where’s the care part?

Here is a little story about healthcare. My mom has good insurance and is healthy. That’s not the problem. But her experience yesterday points up some of the things about healthcare that make you wonder where the “care” part went and how they can be so inefficient.

My mom has chronic back pain. She puts up with it without complaint until she simply cannot take it anymore then she sees a doctor. That is the point she was at a few weeks ago when they wanted to give her an epidural injection. She had had one years ago and had success with it. This time they wanted to give her two separate injections a few weeks apart. They put her under for the procedure and so my husband drove her to the appointments. The first of the series, like the one a few years ago, went smoothly. She woke up feeling good – the best sleep she had had in months. I swear she looked five years younger the next day. All those nights of waking up in pain can really wear a person down.

Yesterday was the second of the two procedures. She and my husband set off for the appointment early, as they requested, to fill out paper work. When she told them she had been in a mere two weeks before, they said it didn’t matter,  she had to fill out all the paperwork again. The paperwork included a note about two narcotic pain medications that she is allergic to. How inefficient is it to fill out the same paperwork again and again! She waits. They call her back. My husband waits and reads all the old magazines in the office. The last appointment took two hours. Two hours go by this time and nothing. Two and half hours go by and people are packing and leaving the office. Still, nothing. I am concerned when I don’t hear from them and call husband every little bit. Nothing. He walks back like he owns the place and finds her. She is asleep. She has been sick from the anesthetic. Her blood pressure spiked. She has broken out into a cold sweat. They have given her medicine for nausea and an IV. She opens her eyes when he talks to her, but is clearly not well.

The nurse fills him in. He asked the nurse to speak to the anesthesiologist. He is informed that it’s a “nurse anesthetist” and that he has gone home. He makes the nurse get him on the phone. After a very heated conversation, my husband learns that at the other two appointments they have given my mother propofol – yes, that propofol, the one that Michael Jackson liked. Now, the “nurse anesthetist” says there is a shortage nationwide of it, so they were trying to limit the use. They gave her a smaller dosage of it and combined it with a narcotic. Husband asked him if there was a shortage of propofol in their office. No. He had no explanation for why he changed the procedure that had worked so well for her previously. Looking at her paperwork, we see where she has written that she is allergic to the two different narcotics. That was never a consideration, that if she was allergic to similar drugs that this one might not be the best choice for her. There was no discussion of a change in procedure. They didn’t ask her about having a different anesthetic. They just did it. Husband stood over the nurse until he saw her write the name of the narcotic in her file and note that she was never to be given it.

Nearly four hours later, they wheel her out and my husband takes her home. I meet them there. She is so weak and sick. I am furious that they have done this to her. We help her get into bed and she sleeps it off. She is fine. She will be fine, but it didn’t have to be this way.

There is something to be learned here. This is a person with good insurance. She is in good health. Those problems, are just part of the puzzle. This story is the part about the care. You can find treatments that work. You can find solutions to your healthcare needs. Yet, it still comes with risks. Never go to the doctor alone. Even for the most minor procedure, it is best to have an advocate. Be vigilant. You have to ask, they will not tell you otherwise. Know what they are giving you. Know what they gave you before and make sure it is the same. If a change needs to be made, make them tell you about it and tell you why. My mom was lucky to have my husband with her. He is a bulldog in these situations. He will not back down. That is how you have to be.

All Politics Are Local

Before we all get too carried away thinking the elections yesterday are a referendum on Obama or the Democratic party, can we take a look at the big picture? When you step back a bit, the picture you get is a little different. You begin to wonder if the body politic is simply schizophrenic.

So the Republicans took the governor’s seats in New Jersey and Virginia. But, 56% in New Jersey and 60% in Virginia said that Obama had nothing to do with their choice of candidate. Obama has approval ratings of 57% in Jersey and 51% in Virginia. So, does it mean gloom for the Democrats? Of course the GOP thinks so. Yet, they had their own loss yesterday in New York’s 23^rd district. The far right made a play for the seat bringing in the fringe. The third party conservative running against the moderate Republican said Glenn Beck was his hero and was endorsed by Sarah Palin. He lost when the Republican withdrew and lent her support to the Democrat. So, is that a referendum on Sarah Palin? Glenn Beck?

We will continue to hear how this election means something for national politics. It doesn’t. Corzine was unpopular with his constituents. His loss is not a big surprise. Virginia? I don’t get how the thesis that McDonnell wrote while at Regent University didn’t seal the deal for Deeds, but if they want to vote for a guy who thinks legalized birth control for unmarried couples is illogical and that women should stay at home… Well, I can’t make much sense out of that.

There were other points of interest from the elections. Maine voters voted against same-sex marriage. On the other hand, Kalamazoo, Michigan voted to add sexual orientation and gender identity as protected classes in an anti-discrimination law and Chapel Hill voted in an openly gay mayor. And while Maine voters seem illiberal on the gay-rights issue, they voted to license medical marijuana shops. Breckenridge, Colorado toped that, though by voting to just legalize pot (of course it is only symbolic as it is still illegal in state law).

It is not all doom and gloom for the Democrats. The GOP had some victories, but the far right demographic had a setback. That is the most hopeful thing that I think came out of the election, that the crazies didn’t win that one. As a whole, the electorate may be a little schizophrenic, but overall the middle of the road will win out. We’re not that crazy!