Being a Patient is No Fun. Pt 2

A few weeks ago, I ended up in the E.R. with a dislocated shoulder due to a torn left labrum.  Anterior, I think.  I wasn't sure if describing my experience there constitutes whining, and I didn't really want to write a blog post chock-full of whining...but it was an interesting experience nonetheless and worth retelling if only so I remember it for myself later down the line.

Different E.R visits lead to different experiences based on several factors - understaffed/overloaded, number of patients and what their health issues are, the hospital's location, and the overall personality of the staff, just to name a few.

Regardless, being a patient sucks, and I can't imagine what it must be like for people with serious illnesses that need extended hospital care.  I felt powerless going into the E.R., even though I've been to one before (maybe it's because this time, I felt like it hurt a lot more).  I didn't want to be touched and I didn't want to be pitied either.  I felt the pressure of several years of guilt too - the knowledge that if I had quit wrestling at the first sign of trouble, maybe I wouldn't have had to gone through all this.  I felt anger - if the first specialist I went to had asked for an MRI, maybe I would have found out sooner how serious this was and quit.

I refused to let anyone help me out of my jacket - I did it myself, inch by inch.  She was nice and understanding about it, and I'm thankful she indulged me.  I fought the doc every step of the way though.  Something about her attitude or tone of voice rubbed me the wrong way.  I found her condescending and it made me feel like I was being treated like a kid who didn't want to go to school.  She planned to use the Stimson maneuver, which involves laying face down with the injured shoulder dangling perpendicular to the bed.  She would then attach four saline bags (roughly 10lbs) and let gravity do most of the work.  I know it's an accepted procedure that is coincidentally less violent than other methods, but it sounds ridiculous to this day.  I remember a previous dislocation where the doc and a med student used a combination of scapular manipulation external arm rotation (while I sat upright) to reduce the shoulder and it was totally, undeniably pain-free and took about 1 minute without any meds.  I tried to explain this to the doc, but for whatever reason - whether she was unfamiliar or uncomfortable with that method or if it posed a greater risk to me that she did not explain - she refused.

It took time for them to coax me into a prone position, and then another several minutes for a nurse to gently move my arm to a 90-degree forward flexion.  After that, they gave me an intramuscular shot of Ativan, which hurt AND didn't kick in until AFTER I left the E.R., and I was left to force myself to relax and spasm in pain until a P.A. came to manipulate the scapula.  Feeling your own shoulder slip into place is one part gross (listening to things slide into place) and one part relief.  Muscles that you didn't know were tensed suddenly relax and you can breathe.

I don't know if I was being a difficult patient or not.  IMO, I think the person two curtain-cubicles down was a difficult patient (until they restrained him).  Even though I was familiar with my condition, knew her treatment plan was going to work, and know what it's like to work with doctors, I still didn't want to trust her.  It's a very primal response, not subject to reason.  I'm just glad the doc went and found a nurse instead. The nurse was much nicer and more soothing.  She let me move at my own pace, which also helped.

I'll remember this incident as an important lesson in communication and patience. Someone who is sick or injured, in pain, and confused (and not under the influence of illegal substances) won't trust someone just because he/she has an M.D.  I'll try to remember it even when I'm underslept and overworked.

After that, I wasn't feeling tired and didn't want to go home just to mope around, so I asked my mom to drop me off at my friend's joint-sibling birthday party.   I wore a sling and was just starting to feel the Ativan kick in.  I have very vague memories of that night, because of the Ativan.  I remember sitting in her little brother's jumpy house, being bounced up and down while my friends jumped around and being very mellow.

Late Night Blogging Carried Over to Noon

I've been alternating between bouts of productivity and bouts of extreme layzee-itis.  I was watching a 2AM rerun of Without a Trace until I fell asleep, and I stayed up the previous night to marathon Battlestar Galactica like the geek I am.  My sleep schedule is preeeeeeeetty messed up.

I finished reading Healing of America recently.  Overall, I liked it.  The author, T.R. Reid is good at explaining the similarities and differences between different health care systems in North America, Europe and parts of Asia.  It's an easy read for someone who doesn't want to grapple with too much professional jargon or someone who wants an introduction into health policy.

I've also been e-mailing professors..My next step will be to set up an appointment with a few of them, which I won't be able to do until a month or so from now, once I'm out of my sling and can make the hour and a half drive to campus.  I was surprised that some of them responded to my e-mail within days...I was expecting to wait along the lines of a month or so, which is why I asked so far in advance.  Oops.

I've also been updating my end-of-the-year AmeriCorps report for Dr. J, the medical director at the surgery center.  The hard part is trying to be thorough without ending up with a 20-page report, which I can easily do since my quarterly reports were easily 10-11 pages each.

On Friday I'll be heading back to Santa Rosa to train the new AmeriCorps girl.  I'll have to get up at 6-ish (ahhhhhhh the horrorrrrrrrr!!!) to take the bus up, but I'm looking forward to hanging out with the staff again.  Hopefully some of the more fun dentists/docs are scheduled to work.

Progress

Somehow, I wasted the last 4-5 days fussing with my computer.  I finally realized that the PC Tools Antivirus Software was making my laptop really buggy, and the latest upgrade made me think my laptop was heading towards a dramatic and violent death.  In the process of figuring out what the heck was going on, I cleaned out my hard drive, backed up data that can't easily be reinstalled, did a full defrag and clean with CCleaner, got rid of PC Tools and installed avast! instead.  Problem fixed, woohoo!!  I really hope this laptop can make it to the 5 year mark...that would save me a lot of money.

I've also been spending a lot of time on e-mails.  So far, I've gotten two of my academic science professors (Biochem and Embryology), one Humanities professor and my old P.I. to write me letters of rec for the AMCAS.  I've kept in touch with my old P.I. and Humanities professor so I feel rather comfortable asking them to write/update old letters.  I am not so thrilled asking my science professors for a letter.  I'll be meeting with them sometime in October (once I'm recovered from surgery and able to drive).  Honestly, I can't expect much of their letters except to say that, based on my good grades, I would do well in medical school (whether that is true, remains to be seen =P).  My Embryology class was considered small for my institution, but it still had 150 students and I never went to office hours.  In all four years, there was only one class where office hours actually helped me learn (Physics). 

I will be getting letters from my former AmeriCorps supervisor and other staff members from the non-profit org, which I definitely think are stronger and will back up my own personal goals for going to med school. 
Over the next few days I'll be putting together a more concise report of what I've done the last several years to show each letter-writer.

I'm also hoping to find a part-time job...one that will hopefully start not long after I'm out of the sling.  I don't think I can study for the MCAT all day every day without going crazy, and while volunteer stuff may look better in applications depending on who I ask, they don't pay bills (or let me buy snacks for MCAT studying) =/

Books

On Thursday, NPR posted the Top 100 Reader-Selected Sci-Fi/Fantasy Books.  This was made public at a rather opportune time...In September I will be undergoing surgery for a torn labrum.  I'll be in a sling for about 4-6 weeks, but I'm not sure what my own level of activity will be within that time.  I don't want to sit on my butt the entire time, but little things like getting dressed to go outdoors will be difficult (and potentially painful).  If I am diligent, I will start reviewing material for the MCAT buuuuuuuut I think I would rather sample books on NPR's Top 100 list.

I'm actually surprised that I've read quite a few of them during high school - 1984, Flowers for Algernon, Fahrenheit 451, and Frankenstein, to name a few.  They are all very sci-fi-y, but I always associated the sci-fi category as books for leisure rather than books for study.

Also, The Princess Bride made the list.  Woohoo!

I've also been reading The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care by T.R. Reid.  I've only been reading it during meal-times instead of devouring it all in one day.  It is a good beginner's book for people who want to learn how health care is managed in different first-world countries.  I may just want to read it again so the info sinks in better.  I might post a few thoughts on it later on...when I'm less lazy :P

Shameless Plug

This is one of my best friend's travel photography blog: The Departure Lounge.
Her pictures make me want to get up and explore, traveling to all the places on my List.  They're always colorful, with different snapshots of the local people, local fruits and landscape, or of cityscapes.

Healthcare and It's Worries

Lately I've been feeling dejected because I've been counting all the times I've been to the E.R for sports-related injuries: 3 times for dislocated shoulder, once for a sprained ankle, another time for a relatively minor chest injury that involved a visit to the E.R. just to make sure nothing was broken. All but the sprained ankle were injuries that occurred during wrestling practices.

Now, all I think of when I recall those visits are the dollar signs. I wonder how expensive that chest x-ray or ankle x-ray was, how expensive my doctor's 10 minutes of consult was, how much goes to hospital admin fees, how much this silly cloth called a "sling" costs. I worry if my insurance will cover it, because everyone hears horror stories of perfectly good, hard-working people turned down for treatment for seemingly no good reason. I wonder how much it costs for a consult with the orthopedic surgeon, Dr. A - I should probably ask.

For the record, I'm not a klutz (or don't think I am), although I was pretty pissed off when I sprained my ankle on an uneven part of the sidewalk.

But still, my health worries are relatively minor in the bigger picture. I wonder how other people and families with serious, chronic illnesses deal with it. For one - cancer patients. Will their insurance cover all the drugs and treatments involved? What if it doesn't? How does a person worry about their life (or their loved one's life), if bills start coming in before the patient is considered "better"?

I'm currently reading The Healing of America by T.R. Reid because it seemed like a good starting point to learn about different healthcare systems.  I'm reading at a snail's pace, even though his book is really interesting and an "easy read."  Books like that, news articles, and the health professionals I have interacted with make me more aware of the current state of the healthcare, which is something I will have to deal with a lot more once I get past the training stages of medicine.