Friday, July 8, 2011

Being of unsound mind and body. . .

"Ordinarily he was insane, but he had lucid moments when he was merely stupid." Heinrich Heine
Acute medical distress recently focused my appreciation of close friends and loving family. What great fortune to have adequate treatment resources available and sympathetic souls offering unconditional support when emotional and physical needs run high. About a month ago, wife Gwen, returning home after working a 12-hour night shift, found my senseless self on the floor of our master bedroom. I vaguely remember being transported to hospital and the next memory comes five days later as a nurse tended my tubes, devices and monitors and explained that I should be pleased the shoulder replacement operation had been successful.

My response, "Operation? What operation? Where is this? What am I doing here?"

Answers came slowly but not completely. Usually, broken bones and bruises are easily explained. More elusive are underlying causes that make one particularly vulnerable to physical injuries. Slips and falls are the leading cause of hospitalizations for injury and they result in thousands of premature deaths each year in Canada. I don't know what led to my collapse but it seems to be an effect of a few treatable maladies reaching crisis point together. All this will become clear in the the weeks ahead, I hope.

In the days after surgery, dependent on a respirator, I was a less than perfect patient. Beyond medical instability, I had delirium. Amusing now but not then. In my paranoia, hospital staff - all but a few anyway - were experimenting with restraints, masks and machines while hiding me from those who cared. To facilitate concealment, my hospital room was shunted from one part of Lions Gate Hospital to another. Mostly, it was ensconced on the sixth floor but it was moved unpredictably, even spending time in a maintenance garage outside the main LGH building.

Convinced of truth others could not comprehend, I was irritated that incoherent speech prevented explanation to others. This inability to communicate was a frustrating part of the hospital experience, compounded by the sense of helplessness from attachment to machines.

As days passed, Gwen gently explained my confusion, assuring that it is common during health crises involving seniors with newly issued gold CareCards. Gradually, the fog of delirium lifted. Disorientation and paranoia are gone but physical impairment and inability to focus attention, while improving, drags on.

In future, I will write further about my patient's view of healthcare. Today's hospitals have gained incredible medical capabilities, in both physical and human resources. I suspect though we are failing when it comes to preventive medicine and post-hospitalization care. I received intensive treatment at Lions Gate Hospital, served by emergency personnel, internal specialists, surgeons, nurses, radiologists, pharmacists, lab techs, respiratory therapists, physical therapists, etc. However, after discharge, I'm stuck in the partial void of community resources.

Last year, our family doc of more than 35 years retired. The medical centre he had joined to facilitate continued patient service refused successor coverage to his clients. After months of searching, we found a GP at another medical centre willing to accept patients. Shortly after, he disappeared without notice. Seeking a new family physician, I have called countless medical practices without success. The situation is steadily growing worse as ageing physicians retire or join hospital staffs. Walk-in clinics may work well for minor ailments but are not the gold standard of long term healthcare.

We have magnificent medical capabilities in Canada but a hugely sophisticated structure sits atop a quietly crumbling foundation of home and community care.

By the way, there was one very considerable factor that made my quick recovery vital. Our youngest child Ryan and his marvellous fiancée Susan were to be married July 2 and I intended to don a tux and join the party. I did, lasting the ceremony, the photos, the dinner reception, speeches and toasts and was in bed asleep shortly after 9pm.

http://www.leehallidayphoto.com/
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15 comments:

  1. Welcome back Norman.
    You were sorely missed.

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  2. Happy you're back and recovering....

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  3. Glad to hear from you Norm,
    You seem feisty as ever, hope that is the case.
    All the best! We need you!
    Don

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  4. Looking forward to more & more of your interesting articles. Take your time however, recovery is a slow process at our age. Enjoy the day.

    Guy in Victoria

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  5. Happy that you're here with us, and hoping that you'll make a full and speedy recovery. I have really treasured your insights and will continue to do so with each new installment, whatever the topic or frequency. I only hope that sea of negative, corrosive events in which we swim won't have a negative effect on your health, as I suspect it does with many of us.

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  6. Glad to hear your words of wisdom.

    Get well!

    Maharg

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  7. Although I've never posted a comment here before, I do visit often. Glad to hear you're on the mend.

    Slainte mhath!

    RS

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  8. It was very good news to learn that you mustered the wherewithal to attend your son's wedding. Good on you, and congratulations on launching an offspring into the good graces of marriage.

    The delirium thing, yup that's a nasty shock. It's often not recognized by the medical profession as a frequent, temporary reaction to the drugs often administered during a hospital stay (not just for older people either, but seniors are more at risk of medical staff leaping to judgment). No sooner than family or the person knows it, the person can be declared incapable by a doctor, and from there it's a short, easy step to losing your rights as a human being, and all your decision-making powers.

    Thankfully for you, your wife is a nurse and also, a nurse knowledgeable enough to know/care about this. Not all do. I'm sure you're counting your blessings, despite having to navigate the post-hospital health-care bureaucracy.

    Recent gold care card, eh? Should be called the grey card. (Sorry, not trying to break any stitches, but humour however slight is a mighty medicine.)

    Despite your wife being a nurse, do watch what drugs you were or still are on though. Best source for checking the potential side-effects of pharmaceutical drugs, bar none, is at Citizen's Watch. Ralph Nader's organization established a site called:

    www.worstpills.org

    It was established in the 1990s to counter-act the misleading information often put out by drug companies, and the pablum offered by the FDA (ditto Health Canada). It's run by physicians and scientists, and has detailed information on all prescription drugs available through a simple search.

    Also, you can check out a source closer to home for you, UBC's Therapeutics Initiative. It's more of a resource for BC doctors and not as comprehensive as www.worstpills.org, but it's renowned internationally for it's work helping to keep BC citizens safe and doctors informed:

    www.ti.ubc.a

    All the best to you Norm.

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  9. Good points about pharmaceuticals and our need to be well informed. I've followed UBC's Therapeutics Initiative and urge that people register to receive the Therapeutics Letter and information of their educational events and publications.

    http://www.ti.ubc.ca/

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  10. Thanks for reposting Therapeutics Initiatives correct website. I accidentally hit the post comment button as I was trying to correct it.

    ps Great wedding photo!

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  11. Wedding party at bottom of post Norman?

    Looks like a mighty fine group around that even finer couple.

    Looking forward to your further analysis - and if this post was written in lingering post-op fog, we should all be so lucky to be this incisive on our best days.

    .

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  12. Thanks RossK. I'm proud to be part of our local, amateur (or mostly non-pro) online community. Readers here are kind and generous but, even more importantly, they mostly contribute worthwhile commentary.

    I've considered the quandary about moderation of comments and conclude we are forced to do it, even though the imbecilic mischief-makers and fools can be counted on the fingers of one hand. All bloggers reserve the right to bounce defamatory comments and I also feel entitled to trash those that are worthless or otherwise harmful.

    The fact is, I block very few offerings of opinion from readers. Do you suppose the mainstream newspaper letters editors can make similar assertions?

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  13. I know well the trials and tribulations of post-op home care in BC.I have had two operations in the last two years on my left foot from complications due to diabetes.Basically you're on your own.Yes I was going to the wound care clinic in West Van two to three times a week and they are truly wonderful people.But in terms of a continuum of care there is none.It was basically stay home,keep the weight off the feet,and let it heal.When you have diabetes that can take a long,long time.Where I found the breakdown was between the podiatrist,the wound care people,and the expertise I needed to determine what kind of footwear I'd need from now on,especially as I work outdoors and need safety footwear.The problem as I see it is lack of communication between various care providers on an ongoing basis so that a comprehensive care plan can be drawn up tailored to suit each individual's needs and situation.That has to change.

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  14. I'm so glad you are on the mend. You have been missed.

    I too had a bad experience. I had moved to a small city. I had no family doctor, and was on a waiting list.

    I have a chronic illness, I have managed since my thirty's. I was spiking a low temperature. I usually wait for a while, to make sure it isn't a flu. When my temp went up and stayed. I knew I had to go to Emerg. I had my son drop me off, saying I would cab home, as I knew he was very busy.

    When I got there. The admitting nurse, asked me why I was there. I had started to tell her. She interrupted me, and asked, what are you doing here this time of the day? I was totally puzzled, and I said, I was feeling worse by the minute. She asked me who My doctor was. I said, I didn't have one. She was very huffy and angry. I was so uncomfortable with her, I really wished I hadn't come.

    The Emerg stretchers, are right in the same room as the Emerg admitting. The Emerg nurse was going to start an I.V. in the back of my hand. I explained to her, from years of experience, the veins in the back of my hand, always blew. Then she was angry with me. I asked her, could she put a bit of freezing in the back of my hand, as the pain was always so intense. She said, we don't do freezing. I can give you an ointment, that is, if you want to sit here and wait for 45 minutes. So, I gritted my teeth, she put the I.V. needle in.

    The Lab came and took some blood. By this time the vein blew, the entire back of my hand was black. The Emerg nurse, had a very scared look on her face.

    The doctor sent me to x-ray, to be done asap. I was light headed and dizzy, so I knew my temp was really climbing. I went to hand my req'u in, the x-ray tech said she couldn't do me. She wouldn't accept the req'u, nor would she look at it, to check the urgency.

    I didn't know what to do. I thought, I can't go back and tell the doctor, I couldn't get my x-ray. I didn't want to cause any more trouble. By this time, I was freezing, I knew my temp was extremely high. I thought I had better get home as fast as I can, and try the next day for my x-ray. That's the last thing I remembered. I have no idea how I got home.

    The phone woke me the next morning. I had made it to the sofa. I had left the door wide open all night. My handbag was dumped on the floor.

    My son asked me, how I was. I told him I didn't know. He couldn't understand me all to well. He came into town. Grabbed a few toiletries for me, and took me into the city. I didn't realize, I still had the I.V. needle in the back of my hand.

    I had pneumonia, an inflamed gall bladder, the lining of my stomach, was inflamed. I had a cute diverticulitis, which has nearly killed me, more than once. A partial obstruction. The bursa in my hip was also inflamed. They were horrified by my condition. My hand was now black, right to the wrist. My temp was 41.9.

    However, I didn't say anything about it. I wanted, no more todo's.

    I was in hospital, two weeks, went home. Was very ill all night. Back to the city hospital, I had a super bug. Thankfully not the VRE.

    Now, they think I have veins blocked. I get severe cramps in my legs. I am supposed to have a, MRI. I have decided not to. I would have to go down to the hospital here for blood work. That I am not going to do.

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  15. Wow, the "Eye" also had a near death experience around Christmas, with seven days spent in Emergency and six weeks on IV therapy to kill the evil humors that invaded my body.

    All I can say is the Emerg doctors were very good, as well with the nursing staff. There were a few 'Nurse Ratchets' around but I would wager every hospital has them.

    The real problem was the 'paper pushers' in Fraser Health who had me discharged me far too early and ordered the wrong drugs for me, as the 'juice' I was supposed to take was too expensive. This caused many problems and added 2 weeks to my cure.

    Happily I have come through, but still have the scars from a massive MRSA infection which almost cost my my leg, if not my life.

    Life lessons everyone.

    1) Spider bites are horribly dirty and dangerous; if you get one see your quack post haste.
    2) If playing sports on grass fields, just do not shower after, have a bath in Epsom Salts!

    Glad to see you back, you are too young for the "Bucket Club".

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