The Miracle or Buffoonery of 21st Century Medicine
Do Doctors Really Care Anymore?
A Great Movie: Fiction or Real Life
Most of you can claim fame to have watched in awe the tremendous performances by Jack Nicholson and Louise Fletcher in the critically acclaimed move from 1975 - “One Flew Over The Cuckoo’s Nest”.
It is still one of the greatest movies of all time yet unfortunately contains some unsavory truths that still exist today in modern medicine.
I consider myself a somewhat healthy person and had been fortunate to avoid surgery or inpatient hospitalization since the year 2000. That all changed two years ago when I began a journey still in progress but hopefully near the end. I shall call my saga rightfully: Guess and Guess Again.
I will reference my remarks regarding three of the largest hospitals here in my metropolitan area generically by letters.
Hospital A: Large city wide network recently enhanced to include numerous hospitals mainly in southern metro. Once known as a lower caliber treatment facility it has recently been updated to a state of the art facility.
Hospital B: Large hospital known for surgical and physician superiority. If surgery was required, it was the best place to go and has always been the number one rated hospital in our metropolitan area. In fact I had three successful surgeries there prior to year 2001. It has recently expanded its network to urgent care centers, nursing and rehabilitation care.
Hospital C: Large metropolitan hospital with branches citywide. In years past it had problems with good care but has recently been upgraded to the number one trauma center in the metro area.
My Personal Background notes:
I have been treated at all three hospitals but because of a botched surgery in 1971 by Hospital C, which left me with collapsed veins and other health issues, I avoid going there although it is two blocks from my home
The Beginning of my Journey
I was fortunate to be gainfully employed by a large insurance company for whom I had worked for 25 years. As I worked in the southern metro area my medical care was received from doctors in that part of town. A desk job left me sedentary and aging faster than I could count the years.
In March of 2013, I had some extensive dental work done which in itself was enough to cause me extreme anxiety. A childhood trauma had left me close to hysteria when approaching the dentist chair. I found myself barely able to breathe at times and was given Valium to control my anxiety. Soon, however, the Valium didn’t do much for me as not only could I not breathe, I could barely walk. I slept for almost two days straight before finally realizing a call to 911 was in order.
My First Hospital Visit
As I was given the option as to the hospital of my choice I selected Hospital A which was in the network covered by my current physician.
By the time I reached the hospital my oxygen level was 40% and blood clots (pulmonary embolism) were my diagnosis. It took about four attempts to secure a vein for the CAT-Scan IV, but even with my collapsed veins, they were successful. I was hooked to oxygen, put on blood thinner and not allowed to get out of bed. Of course that meant all the frills that follow “bed only” routine. An enjoyable process many of you may have endured.
After two days I was moved to a semi-private room and informed I had been in cardiac ICU, a fact which was not previously disclosed to either me or my family. I was a bit baffled why my family had not at least been informed of the seriousness of my condition.
Within a few days my oxygen had risen to 75% and I was allowed some physical therapy and “normal bathroom privileges”. I had tons of tubes and attachments flowing from my body which allowed them to keep careful watch on my activities. I found this out when attempting to stand up by my bedside and sirens went off. Had they informed me of my confinement I would have easily complied.
Eventually, I was allowed to resume normal activity and the blood thinner medication had done its job. I was too weak to go directly home and was sent to a rehab center to recuperate.
The rehab center was nice enough although even the physical therapists wondered why I was even there in the first place. I endured the two week stint which was followed by home therapy and outpatient exercise therapy. All in all I was fully fit and able to return to work in June of 2013.
I was back to work only a few months when my company re-engineered our department and four of us “older” employees were given substantial severance packages and bid adieu. The decision was anything but heartbreaking and I was thrilled beyond belief to have free time for my novel writing.
I stayed on blood thinner for another year at which point I begged my doctor to take me off the Warfarin. I was exercising regularly, lost 30 pounds and enjoying life in general.
Fast Forward to 2015
After my retirement my niece moved to Minnesota from Oregon to have an intricate neurosurgery. Of course having my prior surgeries done at Hospital B, I encouraged her to select a physician there. When visiting her I was amazed at the beautiful lobby of the hospital which now resembled a five star hotel, complete with piano music.
Thankfully my niece recovered but other health issues compelled her to continue living with me and not return to Oregon.
Our Minnesota winter was extremely dry this year and I was ecstatic about the lack of moisture. Little did I know the dry weather was wreaking havoc on the health of several people, including “yours truly”.
Then it Happened
It was early one evening in January when I sneezed and suddenly blood was dripping from my nose. I had never had a nosebleed in my life thus I put my head back and plugged my nose. This was futile as the blood flow was so strong it was filling up my throat and oozing out my mouth and my nose at the same time. Blood was literally everywhere.
My niece called an ambulance thinking I was having some sort of aneurism or stroke. Of course I instructed the ambulance to take me to Hospital A (again) as I refused to be treated at Hospital C just two blocks away.
My son arrived at Hospital An emergency room when the bleeding was nearly under control. His only comment: “Mom, you had a hospital two blocks away from your house and you took a fifteen mile drive for a nosebleed?”
I realized how ridiculous it seemed but as it was soon discovered, the situation wasn’t just about a nosebleed.
The left side of my nose was packed with a lovely inflatable device for keeping in snugly in place for five days until the bleeding artery was healed. Unfortunately, on my way for removal of the packing I slipped and fell injuring the back of my right leg. Visions of blood clots flooded my mind but I pushed them aside, determined not to let irrational fear rule my life.
A visit to an ENT doctor assured me the nose was healed and the bleeding was caused from dry air. My treatment plan was the purchase of a humidifier for my bedroom and use nasal spray. What seemed like a simple solution would prove to be a horrendous event. But we still had to wait for it to happen.
Enter Hospital B
One month later I found myself in urgent care again unable to breathe. I knew the symptoms of my previous pulmonary embolism and the guessed the problem
Even though Hospital B was several miles from my home they had an urgent care facility within a few miles. Blood tests indicated that I could have a blood clot in my lung but needed to verify with a CAT-Scan.
It was unfortunate that the group of doctors and nurses working in the Hospital B facility knew little or nothing about inserting a large IV catheter into a person with collapsed veins. I arrived at the urgent care at 9:30 a.m. and was finally admitted to Hospital B at 7:30 p.m. It took eight attempts to insert an IV in my vein with it collapsing before they could get the CAT-Scan.
The final result was an excruciating port placed into my neck without the proper anesthesia. With eight nurses and doctors surrounding my bed to “watch a process none had done before”, it was anything but thrilling and also caused my son to bolt at them from across the room when hearing my screams.
Needless to say, the urgent care facility used by Hospital B was in need of a more skilled staff. Though profusely apologetic for my pain and suffering they were happy to wave good-bye to me as they placed me in the ambulance.
My arrival at Hospital B proved simple enough and I was placed in room and examined by a physician within minutes. He ordered an ultrasound of my leg and a Heparin drip was started to dissolve the blood clots. I was still breathing fairly well, but the procedure called for oxygen to breathe easier and I was well on the road to recovery. I was allowed to move around, resume normal bathroom activity and just ring for the nurse to push my handy dandy IV pole along by my side. I would be home in a week and all would be well. I was in for a big shock!
The Doctors of Today’s Medicine
As many of you may recall years ago your personal physician always visited you in the hospital and monitored your medications, etc and the entire time you spent there. Today hospital staff doctors oversee your care and depending upon your affliction or problems you may have as few as one doctor or even as many as five or six different doctors.
Now it should be noted that each doctor has his or her own ideas on the method of your treatment, your medications and when you should have them and your length of hospitalization. Although there is one main doctor in charge he or she does not always make the final decision.
All hospitals now have a central computerized system that records everything about you including how often you poop, to what level your pain is at a particular time and what you had for dinner. They know every medicine and vitamin you ingest on a daily basis; they know your primary doctor and how often you visit him; they know every surgery and hospital visit you have ever experienced.
There is only one major problem: Hospital A and its counterparts have one system and Hospital B and its counterparts have a different system. And they don’t talk to one another. Thus if you go to Hospital A in January of 2015 and Hospital B in March of 2015, you will have to go through all your information twice. In fact, you could change everything between A and B and no one would be the wiser.
As my primary doctor is in the Hospital A network he is alerted when I visit an emergency room or admitted to a hospital in that network. He knew immediately both times I entered Hospital A for the blood clots and the nosebleed. Because of the lack of computer compatibility, I had to personally contact him to tell him I was in Hospital B and sign a release allowing him to get information about me. Ludicrous indeed.
The Next Big Surprise
In 2013 I had one staff doctor that monitored everything at Hospital A. He treated me for the blood clots but did not do any testing as to why the blood clots had happened
In 2015 Hospital B was being very thorough and had called in a doctor specializing in blood disorders as well as an internist and a neurologist. They had suggested me trying the newest blood thinner which was Xarelto instead of using Warfarin which needed constant monitoring. I was apprehensive because I had read horror stories of uncontrolled bleeding and was also informed that any unexpected bleeding while on Warfarin could be reversed by stopping the drug or with a shot of Vitamin K.
On my third day in the hospital I was awakened to take my vitals and suddenly had to blow my nose. It was definitely the wrong move to make.
Suddenly I had another gigantic nosebleed twice the proportion of the one that had happened two months prior as now I was on blood thinner. I had asked God for wisdom about which drug to take and He sure gave me an answer --- in a BIG way.
I quickly discovered the cardiac ward in Hospital B was in no way capable of dealing with trauma. I mean blood was everywhere. In January, when I had the first bleed, the EMT’s were immediately on top of it giving me anti-nausea medication and suctioning out my mouth to keep me from swallowing so much blood.
At Hospital B they were running around like chickens with their heads cut off. I had to instruct them to suction out my mouth as I was vomiting blood and it was also running out my nose. At one point they were even admiring my nail polish as I was puking my guts out.
After an hour of bleeding profusely, two plugs were shoved up (one on each side) my nose, (even though I told them the bleeding artery was on the left side) Of course I proceeded to vomit for about 30 more minutes while bent over with my head between my legs. Finally the ENT doctor arrived from the emergency room and informed me the packs would need to remain intact for four days and the blood thinner would be stopped until the packs could be removed.
Try plugging your nose on both sides and then swallowing. It’s a great sensation, sort of like your ears bursting with each sip of water. What I couldn’t understand was why a hospital that was decorated to look like a five star hotel had “one” ENT doctor available and he couldn’t get up to my room until the event had passed.
On Saturday the packs were removed and I was given instructions not to sneeze or blow my nose for two weeks and use ointment daily to keep it moisturized. Cauterization was not considered as that would only cause more scarring and future problems. Of course as the computers from Hospital A and Hospital B could not talk with one another the bleeding incident that happened in January was negated and the recent incident was considered number one. WRONG!
Again the blood thinner resumed but by this time my blood pressure was 220 / 110 and not budging. My head hurt so bad they had me wrapped in ice. After doing double meds on the blood pressure things began to stabilize and the neurologist was able to get the headache under control. The nose bleed was blamed on the high blood pressure and “drying oxygen”.
I left the hospital three days later with Lovenox shots to continuing the blood thinning until my INR level from the Warfarin reached the therapeutic level of 2.5.
Nurses were scheduled to come to my home to monitor the blood thinner. The ENT doctor instructed me if I had another nosebleed of the same magnitude to call an ambulance, call him and he would meet me at Hospital B.
Here We Go Again
I left the hospital on Monday afternoon. Friday afternoon at 3:00 I was sitting in the ambulance with another horrific nosebleed, on my way to Hospital B. I sat in the emergency room at Hospital B for seven hours before I was told that my condition was so serious it required a special procedure call Interventional Embolization. This is where a tube is inserted through the groin or carotid artery up to the arteries in the nose. There they insert special materials to block the culprit arteries from bleeding in the future. The process is 85% effective but bears risk of stroke or blindness if done improperly.
I knew Hospital B specialized in these types of unique procedures thus I agreed to go ahead. The results were mind boggling, surprising and frustrating all at the same time.
Following the procedure I was in a great deal of facial and head pain but was not blind nor had I suffered a stroke. I was sent home two days later assured the procedure had worked like a charm and my nosebleeds were a thing of the past.
Enter Phase Two
Three days after I arrived home I awoke in the night to a small nosebleed. It wasn’t coming through my mouth and seemed quite manageable. I called my ENT doctor who responded at 3:00 a.m. in about five minutes. It was actually quite impressive. By the time we finished our conversation the bleeding had stopped and we agreed that perhaps my Warfarin was off and had caused the problem. We discovered two days later that this was indeed the case as the nurses sent out from Hospital B to monitor my blood thinner had done so improperly. Things were adjusted and fixed and we went along our merry way for about seven days.
Three Times and You Are Out!
You all know the old adage: three times and you’re out. Believe me they had had their final out. I was nothing short of livid when the nosebleed began just one day after I had held my newborn grandchild in my arms. This time, however, things were slightly difference in that I was able to control the bleeding by a clamp while my son drove me back to Hospital B. After three hours the bleeding stopped but I refused to leave until I had some answers. I was kept overnight for observation and the following conclusions were given me the next morning.
1) They cannot go in and do another embolization without knowing exactly which artery is still causing me to bleed. When it bleeds again they will rush me into radiology to find the bleeding artery. This is contingent upon the bleeding still happening by the time I reach the hospital. As I have to hold my nose to keep blood from going everywhere and that option could cause the bleeding to stop it is a perplexing dilemma. As I was not bleeding when they did the first embolization how did they know which arteries to block then? The whole thing was becoming quite a conundrum.
2) The bleeding may just be part of the healing process and I may never experience it again. In the meantime, I am to put ointment and spray in nose daily and carry a big towel wherever I go.
3) When an embolism like this is done, the blood in the nose still has to flow through several arteries and must readjust itself around the blocked arteries, thus the reason for the bleeding period of adjustment. Normally the process has an 85% cure rate. I think they are telling me I’m in the 15%
4) If by a stroke of luck they are able to find the bleeding artery still causing issues and it is one of the two critical arteries that cannot be embolized then a major surgery would need to be performed.
As you can see, all four options are fairly dismal except of course option two or maybe three. Thus far, we have passed the fourteen day mark but I won’t be comfortable going too far without ample tissue in hand until at least three months have passed.
A chiropractor friend long since retired told me if vertebrae in the neck are pressing on an artery, nosebleeds such as mine can persist. Funny how that was never considered even when the horrible headaches plaguing me after the embolization went away when the nosebleed happened. Now the headaches have finally stopped entirely, however, the doctors don’t believe there’s a connection.
Enter Nurse Ratched
I cannot conclude my story without at least giving some credit to the nursing staff at both hospitals. I only had one nurse who was undesirable at Hospital A in 2013, but Hospital B had a few Nurse Ratched’s running around one of whom refused to “bother” the doctor when I was in severe pain after my embolization procedure. She told me my pain meds were ordered only every eight hours yet she was looking at the notes from the prior hospitalization (that lovely computer again). The doctor was furious the next morning when she discovered the nurse’s actions.
One nurse in the cardiac unit appeared to be more on top of things than the doctors but was absolutely rigid in her authority that I not exceed two 325 Milligrams of Tylenol in four hours. If any of you have been in the hospital you know how effective those Tylenol are for killing any amount of pain.
A male weekend nurse was so friendly he sat and watched television with me while administering meds. One night he even took my temperature two times in fifteen minutes as he had forgotten doing it the first time.
I went days without clean towels or clean sheets on the bed. I often had to ask for toothpaste or soap. Nursing aides left towels and wash clothes scattered on the floors because they were too busy or too lazy to clean them up. One aid would constantly leave the room promising to return with a requested item but soon forgot the item and her patient. Most of the food was brought to the room cold and tasteless.
The best part of being in the hospital is when they give you meds for sleep at 10:00 p.m. and then wake you up two hours later to see you are still alive. It’s a real killer.
How do you feel about the current medical care we receive
What Else is There?
At this point in time I’m not at all sure if there is anything good to say about the medicine of today.
I have known more people that go into the hospital for a procedure of some sort and return to the hospital two days later with infection or complications. Doctors seem to guess on a scale of one to five what might be wrong with you. If you have symptom one and two you’re diagnosed one way but if you have symptoms of three and four also then another. It’s when you have one, two, and three but are missing number four or five they become confused as to what course to follow.
I know that seems like an exaggeration but something is not right about our current medical system. They appear to be making decisions of treatment on what the insurance company rules say and not what they believe the patient needs. I had to practically bleed to death before they would do the embolization because it is a costly procedure but also a dangerous one. I have to try to give them the benefit of the doubt and say they were not wishing to take an unnecessary risk but the blood specialist they called in after my second nosebleed told them the embolization was necessary. Yet it wasn’t done until I had suffered the third bleed.
In 1971 I nearly died because of an inept surgeon. How many people die now because of botched surgeries but somehow the truth is pushed under the rug?
What is really going on in our medical profession? Are doctors today really being trained the way they were years ago or do they just not have the same moral ethics of their senior counterparts? When I was bleeding profusely in the emergency room at Hospital B (for the third time) I had one young doctor stop by and tell me how simple it was to stop a nosebleed by simply plugging your nose and tilting your head back. I almost laughed in his face. Apparently he hadn’t even read my chart or didn’t even care.
My own doctor was livid when he discovered the blood pressure medicine Hospital B sent home with me after my first visit was making me so dizzy I could barely stand.
Fortunately for me, I am blessed with a primary physician who cares so much about his patients he calls me every time he is aware of an incident and insists I come in to see him as soon as I am released from the hospital.
The thought that plagues me so much is how many elderly or ill people do not know when they have been misdiagnosed or overly medicated and the mistake costs them their lives.
The personal touch no longer exists. You are a number in a computer and if the computer doesn’t get updated properly you could be toast.
On my last day in Hospital B I had to instruct the nurses three times about my blood pressure medicine that was marked incorrectly in their systems. Each one promised to make the correction and each one failed to their job. My home instruction packet still listed the incorrect medication.
What has Happened to America
We need to wake up and realize something is happening to the medicine of the 21st century. We must begin to be the gatekeepers if we are to ensure our country maintains the quality of medicine we have had in the past.
All the Obama care rules push people out of hospitals before they are ready and good hospitals struggling to survive financially are slowly falling apart. I know one person who has severe Lyme disease and cannot get the one medication he needs because the insurance company refuses to pay for it. They will, however, pay for him to go to doctor after doctor to get a different or new diagnosis to say he does not need the medication. Thankfully, he finally found a doctor that agrees the medication is vital for his survival and has recommended the insurance pay for it. Just think of the year long anguish he suffered because he is not wealthy and was dependent on bureaucratic bull to ease his pain.
Someone has to be the voice of the people. I wrote a long letter to the administrator of Hospital B after my experience, but to date I have not received a response. I once would have always chosen Hospital B for all my medical needs. Now I am not so sure.
This past week I watched the conclusion of Grey’s Anatomy where Derek is injured in a severe accident but is admitted to a hospital which is a non-trauma unit. They had no idea what they were doing and he died because of it. Of course this is fiction but how much is based off reality? I live near a major trauma center and many times am awakened by the helicopters bringing in the injured to save their lives.
Why can’t we expand that computer system to have every hospital listed and their capabilities? When severe trauma happens the patient needs to be treated where their lives can be saved.
Will America one day find itself doing medicine like a third world country? Even now in Europe the cancer cure rate far exceeds that of the United States. Who are we protecting – our economy or big pharma? Are we so blind that we cannot see we will lose the finest doctors in the world because Obama care is pushing them out of the system? The good ones will leave to practice real medicine and who do you think will be left behind?