Saturday, February 20, 2016

Predatory Physician Practices

Who was that masked man? I picked up my father from Providence Park Hospital today. He's been there since Saturday in the cardiac care step-down unit. Not his first tour. He's been twice on the 5th floor, entering from ER with congestive heart failure, and other issues attached to being 85+ years old. This visit went Twilight Zone. Keep in mind he's now 88. This entry was precipitated not by heart issues, but an onset of blindness in his left eye. Associated nausea. This is the first time he saw a stretcher come into his house - he was not breathing the last two times. He was responsive and all signs normal when he left the house. Near as I can figure, within 10 minutes his lungs were full of liquid and he landed at the hospital straight into the trauma unit. From there he was transferred to cardiac care. A different floor. No idea what the difference between the 5th floor and the 2nd floor cardiac care, but the doctor portion of this stage was bizarre. We left today with a list of 8 Practice Attendings. That's groupese for opthalmalogy (2 regular, one surgeon) cardiac (1 who knows, and his crew), one neurologist and a couple of crew. And that's the list of Practices, as the nurse told me. Does not include the rest of the Crew who will bill. The opthalmic issue is serious. He had a CRAO, and is blind in his left eye. A Saturday to Friday stay, and several attempts to talk to a heart guy, and no response. Cardiologist attending - and blimey here's his name - Dr. Raina ordered a stress test. On an 88 year old man with congestive heart failure, peripheral artery disease, a blood clot roaming in his left brain that BLINDED HIM IN THAT EYE, and didn't consult anyone else. Dad thought this was a test he needed to get the hell out of the hospital. He wasn't asked to consent to this procedure until he was being wheeled into the unit. Where am I going, he asked. Sidebar: the photos taken after the chemical stress test had to be redone because they took a picture of the monitor. Another 20 minutes in the tube. And they banged his elbow coming out the photo unit, which is still sensitive. Raina's mission I believe, because he told Dad what he thought should happen was at the least a carotid artery reaming, a heart catheterization, and next a pacemaker. My father had no evidence of any symptom that would require a pacemaker. He doesn't have arterial fibrillation. He hasn't had a heart attack. He has a fucking weak heart because he's 88 and he's got arterial problems. What I found out today, checking his discharge paperwork is that he hasn't been getting his normal course of medications. Two of the heart meds (the ONLY two he's been taking were 1) filled at a cost through Providence Park when he has a 90 day supply from the VA at home and 2) were being delivered to him in the hospital at, in one case 1/2 the dose he's accustomed to taking, and second, 1/4 the dose he's accustomed to taking. I don't do math good, but 30 mg is about a quarter of 120 mg. Perhaps there was a medical reason for this. And here we are. When I called to ask for Raina to call me back, he didn't. He may or may not have told my father he had no intention to call his daughter. My father, bless him, is confused. And that's where this type of medical person steps in. Doctors in specialties dealing with elderly patients and trolling for procedures. One of these birds called me after I was in bed, and then reached my sister, the second on the list to find out if the DNR was real. If the DNR was real. What the fuck is that about? Absent an involved family, your loved one is a potential target for procedures. And billing. I'll fight Raina's bills. And the rest of the Practices that showed up. Opthalmic surgery? My Dad won't because he's that generation, and he has good insurance. This will never happen to me. And I hope it doesn't happen to you.

Saturday, February 6, 2016

Playing with a New Word for Aging

I got to this age the way everyone else does - by hanging around on this planet for X amount of time. What do we call being over 65? I read a couple of comments today without active participation until I decided to make up my own word for an older person. Making up words is more fun than aging. A word's power gets muddied in perception. Evidence crone which has slumped in popular usage over the centuries. Elder, some object to as too Druish. Senior? OK if there's a golf league to join or a discount to be had. Old. Nobody cares much for that because. Flowchart. That person with the wheelchair? Not me yet. If we think of this process of hanging around on earth for X time, (or for the math fans Earth+Time=Old. Maybe X=ET?) as spiritual growth or wisdom plus physical decline that gives me a place to word search. Wax and wane don't quite do the job because the etymology of those words is too close to make a word that's interesting or simple. Wax can mean grow in intensity, whether light in the case of the moon; or power in the case of potential energy (like a wound watch spring). That gives us aug. Augere in Latin, or Olde English, although that leads to augment and that leads to ED junk and I'm not going there. Wane gives us Latin vanus (empty) although I don't believe that etymological root. Ah, Yahoo, so not a root but a word itself. Combine spiritual growth and bodily decline. We're already in the realm of philosophical. Philosophy is not an antidote to science. Started reading a book by a philosopher which I then stopped reading because philosophy + science gets into the realm of gobbledygook. Holding two opposite thoughts in your head at the same time=bonkers. And getting a PhD in philosophy seems redundant to me. So trying to combine spiritual growth, which is potential energy (philosophy), but not applicable to every human's bodily decay over time, which is science and inescapable for everyone born of woman. That doesn't feel as much like bonkers. While the words are fun and highly entertaining for those of us old people who are terribly fond of words, old is old. No judgment on whether there is spiritual growth attained, or wisdom cultivated (and then, even more difficult: prove applied.) Judgment vs. discernment. Adding one more thought into this cauldron. So I'll stop here and go do something simple like laundry. Haven't even touched on the gobbledygookiery of adding anti-aging culture into the hopper. On to laundry...although...Latin de (to turn aside) as in decline, combined with a Latin word for growth silva is cool. Desilva. Turn aside from green? Maybe silva on its own. I am old. I am silva. [Photo: Detroit Bold is excellent coffee.]

Friday, February 5, 2016

My Next President

Imagine it's 2017. The president has been busy, vetting cabinet members, making new alliances and contacting old friends in Congress, firming up gubernatorial relationships state to state. Staff is putting out remaining fires from the campaign, paying bills, making new friends among staff in Congress, reaffirming commitments, bridging differences. Campaign workers are sending resumes for the next job. Newspapers are predicting whatever shiny new or stale old events their editorial board dictates. Life goes on. Politics goes on. Politicos move focus to the 2018 elections. Overseas news services ask what this new prez will do about all the hot spots on the globe. NGOs scribble grant proposals. What's your president doing? If my choice candidate is president, the issues that matter to me are being addressed already. Cabinet nominees are chosen and interviewed. Foreign government allies have been contacted, ambassadors in place or on their way to their new assignments. The first Cabinet positions have been sent to Congress for confirmation. Those posts will be the ones that are important in 2017. State, Education, Health and Human Services, Defense. Women's issues, children's issues will be on the mind and agenda of the President, and foreign policy initiatives are underway. Global governments that are not allies have been contacted as well, told emphatically what will remain the same, what will not. If a confirmation for State can be moved quickly, that Secretary will be on the road now, now, now. Secretary of State Madeleine Albright once said it was a huge diplomatic advantage to land on an airfield and step out of Air Force One. I believe and will vote to help ensure that when Air Force One lands, the huge diplomatic advantage will be that President H. R. Clinton steps off that plane.