A personal medical odyssey

Let’s put it this way, if there is an adventure to be had—even in going to the hospital—it will find me or I will find it.

While the US medical system is a mess, as Michael Parenti pointed out in his article, Free-market medicine—a personal account, and his follow-up article, Free market health care: True stories, what follows below is a positive personal experience.

Some background

For some inexplicable reason, I have become prone to venous ulcers. At least that is what the docs told me: some people get them, others don’t or, in plain English, shit happens.

I have been dealing with one of these stubborn ulcers since January—my third in as many years. Luckily, Ocala Regional Hospital also has its own wound center, which I have been visiting just about every week. I have become fond of the staff there and shall miss them when this is over. But I digress.

The ulcer was being treated with Santyl ointment, which our drug program informed us was not an approved drug so we were gonna have to pay big bucks ($200-$300 per tube) for any needed refills, despite there being no generic substitute; and I was prescribed oral Levaquin for the infection.

The good folks at the wound center sent me down the street to see a vascular surgeon about sealing off the offending veins causing the ulcers. No big deal. It’s an in-office procedure that takes about 30 minutes for each vein, with at least a week between each that requires ablation—and, lucky me, I have seven that need sealing.

On March 15, I went to the vascular surgeon’s office for an ultrasound of my legs—required to pinpoint the troublesome veins. I pointed out the redness developing on my left leg (the one with the ulcer above the ankle) and wondered if I was developing an allergy to the Levaquin, which is a very rough drug. The tech suggested I stop at the wound center before going home and show them the leg. I did and was told to come back the next day, Friday, March 16. Talk about the Ides of March.

The adventure begins

By 4 o’clock Friday afternoon, the redness was creeping up my leg. The wound center doc took one look, said the Levaquin wasn’t working and asked me to which hospital I wanted to go. I opted for Ocala Regional. While he was on the phone making arrangements, his assistant was telling me I had to go pronto.

“Can’t I get something to eat first, then go home to pick up some stuff and do a few things?” asked I. What would Intrepid Report’s readers think if I up and disappeared without explanation?

Eating was okay. Going home to pick up some things was okay. But he was stressed by my wanting to do “a few things,” not that I told him what, and kept saying I must not delay or I could lose my leg.

The nurse who came in to dress the wound also admonished me not to fool around. “It could go systemic and you know what that means,” she said.

The doc told me the arrangements had been made, to enter the hospital via the emergency room and see the triage nurse.

It was about 7:30 when we arrived at the hospital. Before entering, I enjoyed what was to be my last cigarette.

The triage nurse took a look at my leg, told us to have a seat in the waiting room and said she would call us when a bed was available. So after all the fuss the good folks at the wound clinic had made about the horrors that could befall me, we sat in the waiting room for nearly two hours.

The triage nurse calls my name and says she has a bed. A bed? We are led down the hall to a cubicle with a gurney in the ER. My own private cubicle.

After getting settled in—if you can call it that—a tech turns up to haul the gurney, with me on it, away to a lab for another ultrasound of the offending leg.

Back in my ER cubicle, a tech arrives to insert the requisite IV catheter and draw blood. Some time after that, Dr. Z. shows up and announces he is working with our primary doc. Okay. Dr. Z. says he has ordered up IVs of Levaquin and Vancomycin to be administered together twice a day.

Time goes by, then an ER nurse turns up to say they have no beds upstairs, so I will be spending the night in the ER. However, she has sent for a hospital bed to be brought down to make me more comfortable. Okay.

More time goes by and, lo and behold, the hospital bed arrives. It is now 1:30 in the morning and I insist my hubby goes home.

Emergency rooms are not exactly quiet places. Televisions are blaring. A sick child is crying. A woman is screaming as though she is about to expire at any moment. A doctor and the son of a man just brought in are discussing in loud voices his treatment. Another woman is having a loud and nasty argument with her doctor. And so it went.

I tried to concentrate on the book I was trying to read. The same nurse poked her head through the curtain and asked why I wasn’t sleeping. I told her she had to be kidding. I must have drifted off every so often only to be brought wide-awake by a patient in distress or the unmistakable sound of a portable X-ray unit being pushed up or down the hall.

Some time between 4 and 5 a.m., the nurse poked her head in again to inform me there would be no available rooms that day, either, so if Dr. Z. didn’t object, I had the choice of staying in the ER or going to their other hospital, West Marion, where I would have a private room. Like that was a hard decision to make.

Away we go

I had just about resigned myself to Dr. Z. objecting to the move, when the nurse returned several hours later and announced, “You’re moving.”

“Gathering my stuff,” I said.

“The ambulance is here and the paramedics are waiting,” said she.

“You called for an ambulance? It’s only my leg and I can walk fine.”

“It’s required,” she said.

So I walked out of the cubicle to be guided onto another gurney, strapped down and wheeled to the ambulance. At least it was one of the county’s red rescue squad ambulances. Cool. This was a first for me, since I had never been transported in an ambulance.

But before we could go, the paramedic who climbed in back with me came at me with all this biotelemetry. “It’s only my leg,” I said. “Nothing else.”

“It’s required,” he said. “You wouldn’t believe the things that have happened to people we were transporting.”

Finally, we were off for about an eight-mile ride, just as dawn was beginning to break.

To my surprise, ambulances don’t have a cushion ride. I wondered how someone being rushed to a hospital felt being jostled.

The adventure continues

At West Marion, I was taken to a lovely private room with bath—all rooms at West Marion are private—across from the nurses’ station. Handy in a way, but not the best place to be if you want much sleep at night.

Actually, my only complaint was being sleep deprived. Even with the door to my room closed, conversations at the nurses’ station, patients moaning in distress, things being dropped making crashes and bangs, filtered in. Then there was the insanity of waking you up at 4 a.m. to subject you to what I call the torture machine for a blood pressure check.

While I can’t say a negative thing about the staffs at both hospitals, I now freak when I see one of these monitors coming at me. For the first few days, I swear they were coming at me six or more times a day. My arm was so sore from the excruciating pressure of the inflated cuff, and if you flinch, knowing what’s coming, the bloody machine squeezes your arm more a second time.

Fine dining not

I arrived at West Marion in time for breakfast, which consisted of orange juice; French toast; a hot, white pasty substance (cereal of some sort?); Smucker’s Breakfast Syrup; decaf coffee and a pint of 1 percent milk. Also on the tray is an order for a low fat, low cholesterol diet, plus the menu choices for lunch and dinner. Say what?

I queried a nurse about who ordered such a diet and she said Dr. Z. Nice.

So I suffered, lunch and dinner, through soy burgers with dreadful Lay’s baked chips—can’t call them potato chips because they are loaded with corn starch and other yucky stuff—high fructose corn sweetener laden sherbet, angel food cake and Coke, sweetened with you-know-what.

Don’t the hospital dieticians know that most of this stuff is poisonous? Who at home cooks with all these additives, flavor enhancers, stabilizers and preservatives? They even had aspartame-sweetened soft drinks on the menu.

I believe it was Dr. I., the infection specialist they called in, that I managed to get me off the low fat, low cholesterol diet and onto a regular diet. So now the burgers were only partially soy, but by asking for a slice of cheese and some onions, along with the tomato slice, plus some ketchup, mustard and mayo, they were passable.

Hospitalists

I call them Rent-A-Doctors. The concept isn’t bad but the execution raises many questions.

I had a parade of them coming through my room, blurting out their names and telling me they were my doctor for the day, then disappearing into the ether not to be seen again, save for one who said hello once a day, panicked and ordered another leg ultrasound because pain had popped up in my heel, and wound up signing my release from the hospital. He also shocked me by offering Neurontin for the pain—not that I needed a painkiller and especially not dreadful Neuron tin, a seizure medication prescribed off-label for pain.

As for Dr. Z., who said he worked with our primary, would be my doc and is listed on the hospital forms as my doc, he, too, was a hospitalist and I never saw him again after I moved from Ocala Regional to West Marion.

Who these others were and what their specialties were, if any, I have no idea. I suppose if I had needed the Rent-A-Doc of the day that he/she would have come to my aid. But this leaves you feeling like nothing but a number. Nothing human behind the number, so move along.

I have wondered how this must freak out some people, especially with some of the elderly who have a difficult time dealing with change.

Wouldn’t this be a better system if three hospitalists—each with an eight-hour shift—were assigned to a set number of patients? When I asked a nurse how these hospitalists decided on treatments or medications for a patient, she told me they go by the numbers—meaning whatever blood and other tests show.

The next chapter coming up

After Dr. I. first told me I might go home last Monday or Tuesday, then on Monday, saying Tuesday or Wednesday—ah, we know how that game goes—he finally gave the okay for my release on Thursday. Imagine, seven days for an infection when people who have major surgery go home in one to three days.

Now it’s follow-ups with him in his office, more wound center if necessary and getting the troublesome veins sealed. Thusly, publishing may (or may not) be erratic for the next few months. C’est la vie.

Bev Conover is the editor and publisher of Intrepid Report. Email her at editor@intrepidreport.com.