Friday, March 06, 2009

If this is how government medicine works...

Last evening, I received a call from my friend exSailorette, who, having recently had a knee replacement, had suffered from an unusual sort of pain lower in her leg, so had gone to the emergency room at the Veterans Hospital in Iowa City last week.

Now, this is no small thing. We live approximately two hours over open, corn-lined interstate highway away from Iowa City. It's a miserably uncomfortable drive even when you're feeling happy, healthy, and in the mood for a drive. When you're in pain and sitting in a wheelchair... well, you get the picture.

So she went to the VA and they looked her over, told her she had a clot in her lower leg (a "DVT"). They gave her a couple of prescriptions and sent her home, saying that the drugs should break it up, but if she still had problems, she could check herself in to Galesburg's Cottage Hospital, since it's only 25 minutes from home, and they could handle any immediate need. A few days later, the pain was still severe, so she took the drive to Cottage. That was yesterday. The doctor there ran a few tests and discovered that the clot in her leg had not reduced at all in size, and that it was a serious problem. He indicated she needed to be admitted for observation and treatment, ASAP, and made arrangements for her to be seen in Iowa City.

In fact, he was so adamant that she needed to be admitted, he suggested she be taken by ambulance for the journey.

She's had that happen once before.

At that time, she was all alone in the back of the bus for two and a half hours, dropped off at the VA emergency admissions, and, after brief exam, told to go home. At four o'clock in the morning, two hours' drive from anybody she knew with a car.

So she called me. I'm taking antihistamines, so I'm in no condition to drive, but I can keep talking to somebody, if that person needs conversation to keep him awake while driving. exSailorette said her nephew could drive the length of the trip, with company, so I packed up my immediate needs and went with her.

We got to the VA emergency room at roughly 8 p.m.

They took her in for exam almost immediately. At 11:15, she was back out in the waiting room, being given instructions on administering her own abdominal injections of coumadin, twice daily, at home. In other words, she's really at risk by civilian standards, and must be admitted for treatment and observation due to a dangerous clot, but the government doctor says, "go home and stab yourself in the gut twice daily and come back later if you still don't feel any better."

This wasn't the first time my friend had encountered this particular doctor in admissions. Six years ago, she suffered from congestive heart failure, and the doctor dismissed her without a proper exam, saying in effect that, since she had sleep apnea, and she was overweight, she obviously lacked the discipline to wear the CPAP to breathe at rest. He did nothing about her rapid weight gain, nothing about ordering a sleep study, offered no constructive advice at all, and sent her home to die.

This time, he sent her home to stab herself repeatedly in the gut and/or die.

How many people are actually capable of jabbing a needle into their own abdomens? Wait -- let me try that again. How many people, knowing from experience earlier in the day how extremely painful it is to take injections to the abdomen, will voluntarily do that to themselves not just once afterwards but twice daily for two weeks minimum?

I wouldn't go there, and my friend, for all her endurance with back, leg and other pain, was not exactly relishing the idea. (In fact, she still wasn't sure she could do it, as she thought about it all the way home.)

She was given a handful of prescriptions to fill, and directed to the Walgreen's store a half mile away.

This is a woman in pain. Real pain. Imediate pain. And they send her first to get a couple of boxes of hypodermic needles filled with blood thinner, and then drive two hours home again. In pain. And at real medical risk. And, did I mention she's in serious pain?

We waited at Walgreen's for the lone pharmacist to deal with a pair of idiots, then to fumble through the handling of my friend's simple scrip, before getting back into her van and heading back across the Mississippi river to home. Two hours away.

We got back at 1:45 a.m.

I haven't heard from my friend yet today. She knows that, if she has to go back to IA City, either I will be with her, or my mother will. But, quite frankly, I hope she goes to Galesburg as an emergency patient and they give her the material she needs to sue the pants off the anal aperture who sent her home last night.

If this is how government medicine works, and that's what President Obama wants, please leave me out of it. I'd rather die on my own terms than by advice of a sphincter on the government payroll.

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