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Leave them on the Ice Floe to Die: Post Hospitalization Health Care in the United States

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Friends of Padre Steve’s World

Thank you all for your expressions of support, kind thoughts, positive waves, and prayers over the past few weeks. My wife Judy is doing well, her wound is no longer draining, the sutures are healing and it looks like her staples will come out Monday. She is pretty much able to take care of herself and it looks like she will have a good number of visitors while I am in Gettysburg.

Now this has been an interesting experience. You see when someone leaves the hospital after major surgery insurance companies, even good ones are loath to pay for any in-home care, so everything falls on the family of the person, in our case since we don’t have 19 kids to saddle with the work, that person is me. In fact for most people the work falls on their spouse or their significant other, or possibly a teenage kid.

Now I am lucky, I am a fairly senior military officer and I work in an academic setting where I do not have to deploy and have a command that is very supportive of whatever time I need to care for Judy. I don’t have to worry about my paycheck getting docked ort losing my job. Sadly, a majority of Americans have to worry about that if their family member is sick, or needs post surgery care. I think that is a terrible situation if you ask me; condemn Europeans as socialists who pay too much in taxes, but at least they get something for what they pay, most European countries have effective health care and social service systems that do not let people fall through the crack.

For a nation that considers itself the pinnacle of humanitarianism and which is supposedly “pro-life” the situation is shameful, and frankly I think we should be ashamed. We are not pro-life at all, even the people that call themselves that tend to be pro-birth and the hell with you after that, unless you are rich.

Interestingly enough the Commonwealth Fund, hardly a liberal institution, ranked the United States 11th of 11 developed western countries in terms of health care, including accessibility and outcomes, of course all of those countries are willing to have universal health care, and sorry even Obamacare is not socialized medicine, it is simply a modified version of the Heritage Foundation’s plan that they touted over a decade ago and similar to Romneycare. It still keeps the insurance companies in control of most healthcare decisions. If you want to see where the United States ranks here is the listing:

  1. United Kingdom
  2. Switzerland
  3. Sweden
  4. Australia
  5. Germany & Netherlands (tied)
  6. New Zealand & Norway (tied)
  7. France
  8. Canada
  9. United States

The link to the Forbes Magazine article where you can find the report is here: http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/

But anyway, I digress. When a person leaves the hospital the family, with very few exceptions is lead to fend for themselves. Post hospital prescriptions may be covered by insurance, ours are, but nothing else is. If you need surgical pads, gauze, bandages, antiseptic wipes or a host of other potential needs, they come out of your pocket, thankfully mine are deep enough to handle these expenses, but think of the person who lives paycheck to paycheck and because they have to take unpaid leave are not getting a paycheck during their loved one’s illness.

When your loved one is recovering you become all the things that the hospital provides while they are an inpatient. You are nursing services, you get to check, clean and dress their wounds, make sure they get their medicines and monitor them for anything that might be going wrong. Now for me this is not a problem, I have a significant amount of medical background as a Medical Service Corps officer in the Army as well as a hospital chaplain working trauma, critical-care and ICUs. Blood, guts, bodily fluids, I can handle them; spot infection, got it; change dressings, and do other things that gross people out, can do. Again, I am lucky; I have training and experience but sadly when most people leave the hospital their untrained and inexperienced relatives get to do this. The family also is the nursing aid, the dietary service, rehab service, housekeeping and laundry service. It is a full time job, which most families are not, trained to deal with and many do not have the resources to do. Let’s say that because they have to pay rent the caregiver has to leave the recovering patient alone, they are hosed unless perhaps a friend or neighbor volunteers to do this, once again at no cost to the insurance company of the health care system.

For those that do not think that nurses earn their money they are sadly mistaken, nursing is hard, it is physical and emotional. I know why nurses only work 3-4 days before they get a break, it is demanding. Judy often tells me from previous experiences with me as her nurse that I graduated from the Leave Them on the Ice Floe to Die School of Nursing. Now with global warming and the ice flows all melting I had no place to put her so I really had to work hard. Actually, I didn’t mind it, I wanted to make sure that there were no complications and that nothing happened to her I really worked hard to care for her, and I wanted to do it. However, that being said that is what our health care system does to people when it puts them out of hospital, it leaves them and their families out on the ice flow and sadly the ice floes are disappearing. We need to really change how we do health care in this country before they are gone.

PearlsBeforeSwine-28Oct2013

 

So anyway, I am now on the way to Gettysburg to lead 20 students as well as some faculty and family members on my third staff ride of the year. Tomorrow and Sunday I will be out and about the battlefield teaching. I’ll post something short tomorrow night.

Again thank you and blessings

Peace

Padre Steve+

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Deja Vu all Over Again…Back to the ER

It’s like Yogi Berra once said…”Deja Vu all over again.”  Last night after the previous late night and early morning trip to the ER it seemed like Judy was on the uptick. Her pain had gone down and she was looking to get out today. She got up early and the Vicodin wouldn’t touch the pain.  She tried to get in to her ENT for the follow up but was told since the CT was negative that she should come in tomorrow.  Well the pain got worse, and even worser. So when I came back from work we took the ride back to Bayside.  In the middle  of this we have been trying to deal with what we believe is a fraudulent insurance claim.  Some woman  alleged that Judy backed into her in a parking lot.  in a parking lot. The only problem is that the damage doesn’t match how she says this happened. The woman wouldn’t wait for the police to make a report and then filed the claim.  The body shop says that Judy’s car has no evidence of a recent accident.  Then our insurance company representative was rude to Judy seeming to take the other person’s side. This was  totally unexpected as we have been with the company, which caters exclusively to the military and when we joined 26 years ago officers only.  We have great driving records this upset her when she is worried about her health and pissed me off like a bad called third strike.  As Leo Durocher said “I never questioned the integrity of an umpire but I did question their eyesight.”  I hate even metaphorical bad calls and rain delays. May the Deity Herself preserve us and keep me from doing anything stupid when I deal with these insurance people.

epiglotitisReally Bad Epiglotitis

So anyway, Judy got to ride to Norfolk General ER in an ambulance.  She didn’t get the cool Mercedes that I got to ride in in Germany back in 1984, but an ambulance nonetheless.   The EMT’s were nice enough as were the staff at the Bayside ER.  The ER Attending at Bayside and ER Resident here diagnosed that Judy has epiglotitis.  Epiglotitis  is pretty rare, it’s a kid’s disease except when it happens to adults.  What happens is that the flap on the back of the tongue  gets infected and can cause the airway to close, of course this could be fatal if not treated quickly.  It was for George Washington. The infection can be caused by a number of viral, bacterial or traumatic events.  Before the doctors came in with the diagnosis  I  took the symptoms, googled them and hit on epiglotitis.  I was confused because this is primarily a kids disease but the symptoms matched.  When the doctors came in and said that is was epiglotitis I thought it was pretty cool. So to confirm the diagnosis Judy got  to have a scope put down her nose.   The ENT Resident worked her up for this and I both got to even push the watch and even push the record button.  I’ve seen this done hundreds of times but never on Judy.  It is a little different when it is a family member but still kind of cool.    Dr Ly who is one of my ICU attending physicians tells me that it’s not to late to go to medical school.  Maybe after I retire from the Navy. I’d have to bone up real good on advanced mathematics and all sorts of science class but it could be cool.  Of course I could just stick to being a ICU and Critical Care Chaplain and do Bio-Medical Ethics.  That would work too a whole lot less on the school stuff.

Anyway, the verdict is in.  Judy gets to spend the night getting bunches of IV antibiotics, steriods and pain meds. Maybe some more tests and people to monitor her airway.  So I now have to go pick up her stuff at home and bring it in.  I have duty tomorrow so this should be fun. Hopefully she’ll be out tomorrow with a clean bill of health.

Keep my girl in your prayers,

Peace,

Steve+

Post Script: Got home just before 0200. For Civilians and Air Force types Mickey’s big hand is on the 12 and his little hand on the 2.  It has been long and exhausting.  Trying now to gear down, pet the dog and get ready for bed soon. Have to be up early, oh crap, wait it is already early.

Second Post Script: Got Judy home this afternoon.  She is doing a lot better and the crisis seems to have passed. Over the past couple of days I have been moving fast and flying low. Had a few things happen that I will roll into a post tonight. As Hedley Lamar said: My mind is aglow with whirling, transient nodes of thought careening through a cosmic vapor of invention.  Now someone say “Ditto,”  Peace, Steve+

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