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Old 07-25-2011, 12:27 AM   #1
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Angry Impact of Health Care Shortage - Our Story

Some months ago - March I believe, my SD was sent home from work. She had some pretty bad abdominal pain. She didn't want to go to hospital; chose to ride it out at home telling me she thought it might simply be particularly bad period pain. She had to call in sick the next day but returned to work the day after.

Over the winter months, she'd been complaining of odd stomach cramping, digestve changes & her fanily doc had dismissed it as IBs - without giving her any advice on how to deal with that. Bear in mind that for all her many flaws & faults, SD is not one to randomly take sick days nor, since she's become an adult, use 'being sick' as an excuse to get out of things.

A month later she was hit with pain so bad she had a friend drive her to the nearby urgent care center. They transferred her to emerg & at that point, we went in. She was in bad shape. Morphine was barely touching the pain. Over the next 24 hours, gastro signed off on her as did a few other specialities. Gyne said they thought she had an ovarian cyst, ultrasounds & MRIs had been inconclusive. They sent her home with no helpful advice or genuine diagnosis. If it hurts, take Tylenol & Ibuprofen. Her family doc wasn't mcuh better.

It just got work to the point where she was having to take so much time off work, they cut her to part time, leaving her just enough hours to pay her bills & qualify for benefits. Her doc pissed around, repeating the same nonhelpful blood tests & ultrasounds. I finally went in & insisted on a gyne consult - tis was in MAY. I also insisted the doc give her an Rx for something for pain - ridiculous to expect bloody Ibuprofen to help - it hasn't been.

She only just saw the gynecologist THURSDAY. There is some sort of lesion on the right side - not sure where exactly but on her 'female bits'. Makes sense - most of the pain is on the right. Gyne said an emergency laproscopy has to be done - she'd be called. Sent her home with a better Rx for pain - Tylenol #3 nnot cutting it & this is getting worse every month.

Gawd only knows when she'll be called for the laproscopy - could be weeks or longer just to be called with her booking. NOTHING was explained to her - simply signed a consent for the procedure as well as an open ended clause stating if the doc saw something she could deal with while she ws 'in the abdomen'; then to deal with it. Remove lesions, cut adhesions - that sort of thing.

This has dragged on 5 months now & we still have no answers - not even a thorough investigation yet. If we weren't so short GPs, she'd have ditched this doctor ages ago - so would have my SO. Her EMERGENCY gyne consult took 5 weeks to get. No idea when she'll have the procedure. I read the material & told her to book her pre-op physical tomorrow - her doc can take over 6 weeks to see for an appointment.

This is just pure bullshit. It gets worse by the month, she's fed up with missing work & is lucky they didn't simply let her go. She's been one of their best workers though so they're trying to work with her. She's in almost constant pain now & does her best to work around it. Because of her weight, she's higher risk for surgery - not a word was said about that. Luckily she was willing to listen & is trying - she's managed to lose 10 pounds but much of her excess weight is abdominal so her risk of slow healing & infection is high.

She's never hd anything more than a toenail partially removed - no idea how she'll do with the surgery & after. What concerns me is the gyne told her to expect a two WEEK recovery just from the laproscopy... wth? No explanation as to why her recovery should be 3-4 times normal.

I suspect she's got a galloping case of endometriosis. We've discovered it runs in her dad's family & from the pain & other symptoms she's describing, I fear she's got a belly full of it. If that's what she has, it's most likely going to be a lifetime issue with a lot for her to learn in order to manage her condition. I'm not sure the local resources are there.

This just really pisses me off.
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Old 07-25-2011, 01:52 AM   #2
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WTF? 5 weeks for an emergency Gyn appointment??? You have 20 OB/GYNs listed for a 2006 population of 117,000. We have 6...yes, SIX...for a population of 75,000. We have one for every 12,000, you have one for every 5,800. What the hell is wrong with them!? No woman would wait that long for an emergency appointment here...are yours the only ones doing pap smears, or something? Good gawd!!
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Old 07-25-2011, 09:33 AM   #3
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I know people here are all hot for some kind of socialized medicine but I think I will continue to pay for the uninsured who flood the ERs instead of a system like that.

Well, I don't want uninsured flooding ERs but what I would really like is some simple HUGE risk pool where the uninsured could buy insurance. Not some tricky thing like Obama Care. Not a plan where you could buy in one month, get stuff done, then bail.

A real plan like the working insured.

Can you image if all of the working uninsured into a single contracted risk pool the cost savings you could get.

It would make the discounts on the cheesy 250k employee discount we get pale in comparison.
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Old 07-25-2011, 10:02 AM   #4
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The rots of the problem here are deep. Several decades agao we had two acute care hospitals - the General & the Hotel Dieu - run by the local nuns. Both hospitals provided excellent care. When the prvince took over the health care system, they decided we didn't need two acute care hospitals. What they were smoking when they came to that conclusion is beyond me. It's not as if there had ever been much idle bed space at either facility. The city & area hosts 7 or 8 prisons & most prisoners' families live in the area. They bring with them a ton of medical needs brought on by poverty & poor lifestyle choices. We have a lot of elderly.

As it stands now, the General prvides inpatient care for everything save pediatrics - that's still done at the Dieu. The Dieu handles about half the outpatient stuff in the city with the rest at the general. It also does day surgery & runs an 0800 - midnight urgent care center for 'routine' emergencies.

Specialists won't move here to practice because they can't book MRIs & other specialty tests in a timely manner. They can't get their patients admitted in a resnable amount of time. rb pointed out we have 20 some obs/gyn listed for this city. It's a weird glitch in the listing system that you stay on the list, even if retired, if you're still current as an MD. Docs who teach at the medical school & who do mainly research are also on those lists, even if they see few or no patients. In reality, we have about half that number practicing & SD tells me that some of her friends who recently chose to get pregnant are having to wait several months for initial prenatal appointments with an obstetrician.
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Old 07-25-2011, 11:50 AM   #5
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Sue, there's something wrong, besides those points. We had two hospitals as well, one run by the nuns. We also had the split in services. They merged at some point, and since March, in a new building. Of our six docs, I know one for sure is semi-retired, and has been without hospital privileges for more than a decade (politics)...he was mine. As to numbers and newly pregnant women, I was in Abbotsford, BC in 94, when I became pregnant for the first time. Pop was about 120,000. In Abbotsford, a pregnant woman never saw an OB unless there was a big problem...you only saw your family doc. When DD#1's movement suddenly changed around 8 months, I was sent for an ultrasound. The results were sent to an OB, because she was Frank breech. He saw me once in the hospital under ultrasound to turn her. Had she turned, that would have been the last I saw of him. She didn't. On the spot, he scheduled me for a csection a few weeks later. He did this because Abbotsford had only 3 !!! OBs, one fighting cancer, one in Scotland because his mother was dying, and himself.

I think something else is going on in your city, and politics may be playing a part. That's more likely to affect test and procedure scheduling. Five weeks for a consult is ridiculous. Are a lot of them young women? Are they all working part time? Are they all taking the whole summer off? Also sounds like her primary doc may be an issue. Some docs have their patients seen much faster than others.
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Old 07-25-2011, 11:47 PM   #6
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personally I think at this point I would tell sd to go to er screaming in pain and keep wailing and then throw around lawsuits and lawyers in the er if they didnt get in there and take out whatever it is that is causing all of this... there is NO reason for this kind of medical care.
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Old 07-26-2011, 12:27 AM   #7
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It was the early 80's and I was told to wait a year for surgery for endometriosis-I was encouraged to try birth control pills-YUCK, didn't help. And yeah, at the time I did end up without a job for a few months cuz working 12-15 out of 20 work days just wasn't something I could talk a company into doing. lol

Hubby had the job and the insurance-back then, through HP, so it wasn't sucky insurance. Looking back I think it was my age....they wanted me to be ready to be sterile...which I wanted to be anyways.....but that is not normal for a female in her 20's....

I'm sorry things have not changed enough that they are listening to her and doing something faster....

I don't remember if heat or ice pack to the tummy helped the most....

Edit: if she has heavy periods and bleeding she might want to go to the ER during that time so they can see how bad it is during the worst of the flow....and check her for anemia then too....
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Old 07-26-2011, 12:41 AM   #8
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She can't act that well & there's no point. It would actually make matters worse for her. Remember, she has moderate to severe, (situationally dependent), anxiety disorder & even thinking abut trying to pull off something like that would lead to her falling apart. Our bed shortage is so bad, (pretty habitual), that if she went in with real pain issues due to a flareup, she'd be kept in emerg in a cubby, monitered & kept on pain meds until the pain was under control. Then she'd be sent home to wait for her laproscopy. Yeah, we're a cesspit here for medical care - too many shortages of all manner of medical assets. Much screwage of pooches going on including a contract lab that sucks - but that's a different nightmare involving SO...

We unfortunately have a population that's 'rich in addiction & entitlement attitude' & the emerg staff aren't stupid. The only way she's going to get an emergency laproscopy is if a white cell counts suggest she's riddled with gangrene, her intestines are blocked or smething equally ghastly. Our population is leaning heavily with people living crappy lifestyles, lots of addictions, tons of chronic disorders... we're a grossly unhealthy city & it gets worse by the year.

I don't imagine she'll have to wait too long. But she's scared spitless & needs time to process this. I need t sit her talk & talk her through - in excruciating detail, everything that will happen from when she signs in that morning to when we take her hme - right down to details such as operating rooms tend to be kept cold. She's also concerned about her weight & how it may complicate her surgery & recovery. She's accepted that post-op, Nurse Ratchett is in charge for a few days. When I tell her to get her ass out of bed & walk a few minutes, she will. When I tell her it's time to rest, she will.

She's lost 10 pounds in the past 2 weeks & frankly, every ounce she loses will help. Most of her excess weight is abdominal & she's already a slow healer for minor cuts. She's put me 'in charge' of her eating - not a role I'd normally accept but with her psych issues, this is a lot to deal with for her. She has a million questions about surgery & anesthesia, the OR suite & why she has to have an IV. Will she have a breathing tube? Catheter? Every single unknown is terrifying for her. I'll go so far as to - in 'fast forward - rehearse with her the procedure day. When I set up her room, I'll explain every thing I do, from draw sheet to blue pad to what I'll use to dab her incisions clean.

So a bit of delay is not unwelcome right now but nevertheless, we shouldn't have to be coping with this. It's been 5 mnths - we should have had her go through all the testing laproscopy, have some answers & a treatment plan well underway.

Other parts of the province are better served by far. I wish I knew why things are so screwed up here.
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Old 07-26-2011, 12:45 AM   #9
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Sue, for my hysterectomy- before they could do it as a lap-, I had a block like for childbirth and ativan IV.....demerol shots afterwards....no breathing tube. So she may or may not need an ET tube.
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Old 07-26-2011, 01:12 AM   #10
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Probably not. The gyne explained that the MRI showed a 'lesion' in her abdomen but she needed to have a look through the laproscope. I wish I'd been there but had to work that day. I'd love to know just what the gyne thought the 'lesion' is.

If it's endometriosis & I strongly suspect it is, it's probably visible tissue that shouldn't be there. SD understands if the doc can remove what's there through the laproscopic incision, she will. I'm not sure she grasps that if that happens, it may not mean the end of surgery - that all depends what exactly they find.

She's struggling to understand the condition - hell, so am I. It's complex & confusing... & chronic. Dealing with it will take patience & persistence, two qualities she lacks right now. I don't think she grasps, even though she's been doing some reading - that there's rarely a permanent cure but rather, management by trial & error.

For now, day by day, I'll mentally prep her at a pace she can handle. It's a common & routine procedure & I'm not anticipating anything more complicated then her maybe needing a few extra days to feel like herself again. As for me, I simply want to know the diagnosis. Until we have that we're floundering, dealing with symptoms as they come up, (hot water bottle helps with the pain) & hoping there's no unanticipated crisis.
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Old 07-26-2011, 09:19 AM   #11
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This should be the first time the surgeon has had to deal with a person with heavy anxiety disorder.

Heavy pre-op anti-anxiety meds, roll her in stoned, anesthesia right away, and then do the deal.

If they will cooperate.

Well, at least there is some weight loss in there. Who know, maybe she will begin to feel lighter, like it, want some more and it will be the beginning to getting to "normal" weight for a endomorphic person.
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Old 08-05-2011, 01:46 PM   #12
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Default Update

Yesterday marked two weeks since her gyne appointment & being told she needed an emergency laproscopy. Wednesday, she still hadn't heard & asked me if she should call the doc's office. Of special concern, shifts are up for bid at work.

So she called yesterday, her day off. Doc's office told her she'd be called 'sometime in September' with her procedure date & that said date would probably be several weeks out from that. SD asked if this ws an 'emergency' schedule, what might cause such a procedure to be done mor quickly. Basically, a suspected ectopic pregnancy. Other than that - they're just that backed up - not nearly enough OR space in this bloody city.
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Old 08-05-2011, 02:04 PM   #13
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I've seriously considered starting a company that provides medical tourism. You story would be a real world example of why it is necessary.

IE fast service, inexpenisive.

It's kind of hard to find any good source on the web for a trusted source of info however.

Nevertheless, google thailand medical tourism, and start calling for cost bids.

The danger of waiting for "free medical care" might be outweighed by the cost of paying for care yourself.
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Old 08-06-2011, 02:44 AM   #14
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There are already travel agencies specializing in medical tourism.
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Old 08-06-2011, 09:37 AM   #15
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Quote:
Originally Posted by Ought Six View Post
There are already travel agencies specializing in medical tourism.
Here's one that was pointed out to me a while back.

I know nothing about the place, I just had the link in my files http://www.costaricanmedicalcare.com/
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Old 08-06-2011, 12:29 PM   #16
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Quote:
Originally Posted by Pablo Escobar View Post
I've seriously considered starting a company that provides medical tourism. You story would be a real world example of why it is necessary.

IE fast service, inexpenisive.

It's kind of hard to find any good source on the web for a trusted source of info however.

Nevertheless, google thailand medical tourism, and start calling for cost bids.

The danger of waiting for "free medical care" might be outweighed by the cost of paying for care yourself.
Quote:
Originally Posted by Ought Six View Post
There are already travel agencies specializing in medical tourism.

Like O6 said.

I would sign up as an agent if I were your.

Someone else has already done the leg work, especially places like Costa Rica.

There are some cheaper places, Thailand comes to mind, but you are going to want to fly business or first class especially post op and that will eat up a log of the savings.

It is only 5-6 hours to Costa Rica, IIRC.
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Old 08-06-2011, 02:56 PM   #17
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Panama, Mexico, India, Taiwan, China and others are vying to become the medical tourism destination of choice for the wealthy industrialized nations.
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Old 08-06-2011, 08:40 PM   #18
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Taiwan yes, Panama, ok.

India, no. China only Beijing and Shanghai at the moment.

Still flying after operation from Asia in Coach would be a deal killer for me.
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Old 08-06-2011, 11:58 PM   #19
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My brother was just in India, and had some colon polyps removed. He had the operation, and then was taken to a seaside resort to 'recover' for a week. The entire thing; the operation, the resort, food, hotel, transport from the hospital to the resort; under $2k. It is cheaper to fly to India for wealthy Asians and Europeans than to Central or South America. The quality of the care in India is top-notch, as most of the doctors are trained in America or Britain.
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Old 08-08-2011, 01:09 AM   #20
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Mary Lou Ballweg of the Endometriosis Assoc has written some good books on diagnosing and treating endometriosis. The assoc also puts out a newsletter that was very helpful, but it was $35 a year. I don't know what they are charging now. It is a disease where the patient really needs to read up and know their options because in my experience doctors have little interest in this condition. Some of them will give you really stupid advice.
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Old 08-08-2011, 01:19 AM   #21
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Oh, and by the way, it is as you said a chronic condition, but for many women menopause brings an end to the problems. I know for a young woman that's not too hopeful but at least it is not a life long problem.
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Old 08-08-2011, 01:39 AM   #22
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Thanx Cottage. I'm afraid she's still at the stage where she's deluding herself. She seems to feel, in spite of being told & doing some limited reading that tells her otherwise - that's there's a magic solution out there involving little to no effort on her part.

EVERY SINGLE TIME she eats something 'inflammatory' it triggers an episode. I told her the more weight she lost pre-procedure, the better she'd do. She's not even trying. And no, I'm not nagging her or even 'offering advice' - there's no point. She won;t listen & just digs in her heels. She hears what she wants to hear - period.
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Old 08-08-2011, 06:54 AM   #23
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I remember a dr that told me having a baby would help lessen cramps. He lied. I had a friend that was told by her dr that the best cure for endometriosis was getting pregnate even though having it can cause problems when trying to get pregnate. This was over 20 years ago.

All this is why I am so glad my dr is female, she knows what women go through.

I hope they get your SD in soon and get her to feeling better.
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Old 08-08-2011, 09:25 AM   #24
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I had two kids, and strongly suspect that I had endo from a young teen. It got significantly worse in my late 20's, but the military doctors said "Oh, no, it can't be endo. You have two kids, and it only effects childless women." Along with the strong implication that "It's all in your head. Quit malingering."
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Old 08-08-2011, 10:36 AM   #25
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That's the reaction I got from the last male dr I had Mama. Every pain was in my head and could be cured by exercise.
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