Or…I should’ve chosen the colonoscopy.
||| ORCASIONAL MUSINGS BY STEVE HENIGSON |||
A few weeks ago, I told you about my very clever way of avoiding the perils and discomforts of colonoscopy: I contracted pneumonia. But it turns out that I wasn’t clever enough by half. My body decided, all on its own, to add pericarditis to the mix, and then it threw in pericardial effusion as a bonus prize.
I guess that definitions are in order. Pneumonia? Lung infection. Both lungs, in my case. They fill with semi-liquid crud, and breathing becomes difficult, but coughing becomes frequent and painful. Pericarditis? Infection of the pericardium, the sack which surrounds the heart. It becomes inflamed and filled with fluid, and the heart struggles to pump blood, and wants to quit its job and retire to Florida. Pericardial effusion? Liquid of one sort or another keeps invading the pericardium, and keeps the heart feeling very annoyed.
Thinking that my problem was merely a heart attack, our EMTs shoved me into a helicopter, and sent me off to St. Joseph’s in Bellingham. But no, it really was pneumonia, for which St. Joe’s filled me full of antibiotics. Those antibiotics had the interesting side effect of promoting diarrhea, so, much too frequently, I experienced the incomparable pleasure of gasping desperately for air as I went galloping toward the nearest toilet. After four days of this, the medication had finally worked its magic, and I was sent home.
But then the pericarditis made itself known. That was much less of an emergency, so the ferry system carried me off to Island Hospital in Anacortes. I can tell you with complete confidence that Island Hospital is my resort hotel of choice, not least because the food is really good. Island Hospital’s physician told me one of those things that a patient never wants to hear: “Your case is…interesting. Really, really interesting.” But even so, four days later I was on my way home again.
A day later, the EMTs were back. I was once again having sharp, unrelenting chest pains. “Heart attack,” they said. “To St. Joe’s,” they said. Heck no, I said. Anacortes, please. And so, once again I was stuffed into a helicopter. This time, the whirly-bird had serious problems with shake, rattle, and roll. Now, I know that a helicopter is merely an assortment of associated parts, all flying in formation, but on this trip the judder, clank, and shake was just a wee bit overemphasized. I must admit that we did land safely, though.
This is when the pericardial effusion showed up. The pills to reduce that little number had me filling Mr. PeeBottle about every half hour, but at least there was no running and no shortness of breath. And, as usual, four days later I was home again. Home now included a source of oxygen, to which I am still connected by a long tube, and the requirement that I spend the vast majority of my time in my most comfortable chair, unmoving and resting, probably for the next two months.
My first visitor, during my convalescence, was my dear friend Pat. She looked down at me, temporarily anchored to my chair and tied to my source of oxygen by that long tube, and she said, “You know, you should’ve chosen the colonoscopy.” And, of course, she was right.
Steve, I so enjoy your “occasional musings” and hope that you are well on your way to a full recovery, and, eventually, that dreaded colonoscopy. Best wishes!
What the heck does “interesting” mean!?
Or.. is good food really the measure of “good” when talking about hospitals and chest pain?
I trust our Orcas conversation regarding healthcare, emergency care, and local control of care will become better informed.
When StJoe’s surveyed me about their menu, I refused to rate, but wrote: “IRRELEVANT.” Whatheheck do we pay these people for? Good jello!?
This matters when it is a matter of living a rescue-flight or a day’s-worth of ferrying away from “normal” care.
Did EMS or StJoe’s or IH give your primary care doc a full report and collaborate on your plan of care? Or is it a big guessing game that relied on you the patient to provide all continuity? What actual documents changed hands amongst the ..what, five different providers you had? Plus home care?
We need to upgrade our expectations appropriate to our unique circumstances. When we talk “urgent/” “unscheduled” care we are not just talking about having a doc, some doc, “on-call.”
We are talking about “Access” as the prime factor in livability for Orcas seniors. It is not a budgetary line item to expect that our healthcare professionals are supported in their care, & communicate .. collaborate, effectively, -With US, and amongst themselves.-
And it is worth knowing that this expectation can be made explicit as we negotiate our new healthcare system. Yes. This wheel is already invented.
+Reliable funding: step one.
+Streamlined, responsive to our needs: step B.
+Full authority, responsible to provide full access. Step III.
Since access is limited out here, it makes us consider what “Access” really means.. not bells and whistles.
It’s not expensive; it’s just a smarter -appropriate- way to care, that never appears on a balance sheet, but matters. alot
Leif, “interesting” means that my case was puzzling, hard to diagnose, hard to treat, and generally strange. Maybe even weird.
However, there was full exchange of information among all of my providers…except, to some extent, St. Joe’s.
And all of my providers, including St. Joe’s, sent me off with very specific diagnoses and very specific treatment-continuation plans.
My local primary-care provider receives reports from my cardiologist, and soon will also receive reports from my rheumatologist.
And if I request it (which I routinely do), I can receive most of those reports as well. I can also get answers to my questions freely, via e-mail (and I do that too).
Steve, I was not there. You apparently have had a uniquely perfect encounter interfacing with the off-island healthcare system, characterized by “full exchange of information among all of my providers.” What I’m criticising is not your experience, but the *well-established* national pattern that disproportionately influences people with “interesting” or complex clinical pictures, often older folk. And that this profoundly affects folks in rural areas at a distance from population centers is well documented, and in the national press. The question is whether we can create a local system that effectively addresses this as a common good.
Now, it is common knowledge that one can have a local EMS encounter, spend days in critical care off-island, and return, your primary care Doc none-the-wiser, and you responsible to fill them in because you cannot get your own medical records, literally, transferred from across the street, much less from Bellingham, Anacortes or Seattle, without special dispensation.
Orcas has also been profoundly affected by the history of nasty local politics, making provider turnover frequent, dependence on EMS inappropriate and costly, and collaboration fraught. This all within the context of a -then- aging population rightly called “The Silent” generation who denied cracks in the system out of “loyalty” ..And fear of being ostracized even at risk of ill-health and death. [It is from this generation that we get the term “passive suicide.”]
In healthcare, there is a term and concept called “sentinel event” that means that in a highly integrated system, ONE occurrence defines a dangerous trend, and cannot be erased by concurrent “perfect” encounters. It is common to joke about irrelevancies.. like institutional fare, when the important things have been so long so fraught that we no longer know the appropriate words to voice our concerns. So I submit “Access” as a neutral word supported by much research and even addressed by Best Practices and Federal programs as a way to break the logjam.
I bear witness.
Deep sympathy to Mr. Henigson and his wife. His columns get better and better! Best convalescence reading I can suggest: Neil Simon’s Memoirs. Next best, and in a different vein: The Deepest Well, by the wonderful Jamaican doctor and health encourager, Nadine Burke Harris, MD. Best wishes for a flourishing colon. Jan Koltun