scribbles tagged ‘healthcare’

Identity crisis

Tuesday, January 31st, 2012 | tags: , , , ,  |

Identity CrisisIn the ACCU (Adult Critical Care Unit) I found Tiger with 3 identity label tags on his wrists

Two wristbands were identical and accurately stated his name and date of birth. He’s the same person 2 times. Split personality?  The other wristband was placed on him when he arrived, when he was unconscious and alone – they didn’t know who he was. This wristband had his date of birth as 1st January 1900 and named him after the mouth of a river – Delta

Looks like Tiger has a 3 way split personality and is looking good for being 112 years old

Identity crisis
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regular pain akin to breaking an arm is ‘probably ok’

Wednesday, January 25th, 2012 | tags: , , ,  |

The Consultant’s interpretation of my message during our meeting doesn’t match my understanding. This is what I recall telling him:

“I’ve broken my arm on 4 different occassions, the pain of breaking my arm was always less than the pain I experience during the first hour or so of my periods”

This is what the consultant wrote in the letter refering me back to my GP:

“She admits to having pain during period for an hour or even a day or two this is probably ok”

After reading this I’m no longer suprised that I had to ask him about ways of allieviating the pain – he thought this level of pain was ok. I’ve never thought that extreme pain was ok.  I tolerate it, often by being unconscious (fainting). Occassionally I’ve visited the GP to ask if there is any way of allieviating it because the fainting is a bit disconcerting for people around me and not very nice for myself either. I’d rather my body didn’t feel the need to switch my brain off. Luckily the shutdown is slow enough, like Windows 7, that I can make sure I’m safe before loosing total consciousness

 

regular pain akin to breaking an arm is ‘probably ok’
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two little words

Monday, December 5th, 2011 | tags: ,  |

I got my wishno surgery!

I’m normal (Clinical diagnosis)

The route to this radical, yet  insightful, diagnosis required a hospital referal to get a clinical consultants’ opinion. A medical second opinion. That’s a verified, safe, judgement.  I suspect that my waving an unused sanitary towel at the consultant did the trick! What could be more normal in a maternity department? Waving unused sanitary towels is probably a daily occurence

Normal

service is resumed

 

two little words
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dark spot

Saturday, December 3rd, 2011 | tags: , ,  |

Specimen drop offDoctor: are your periods heavy?

I’ve always found this question difficult to answer

What is ‘heavy’?

Pressumably the doctor means the volume and rate of blood-flow from my womb. But what is ‘heavy’ as opposed to ‘normal’ or  ‘light’? How can I judge the fit between my experience and the medical classification?

I’ve never actually tried to systematically compare the rate of blood-flow from my body with that of one other woman let-alone with a sufficiently large number of women to get a sense of what  ‘normal’ blood flow is and how my experience compares to that.  When asked this question before, I’d answered with an honestly unhelpful –  ‘I don’t know

This time I whipped out an unused sanitary towel:

I fill one of these every 2 hours during the first day, then one of these every 4 hours on the following day and every 6 hours on the 3rd day. If that’s a heavy period, then I have heavy periods

Is that a heavy period?

The doctor looked expressionless, he igored my question. I didn’t find out if I have heavy periods, but at least I’ve found an easier way to convey the actual flow rate

dark spot
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why are you here?

Thursday, December 1st, 2011 | tags: ,  |

Follow the yellow spotsMaternity Reception Nurse (MRN): I can’t find your file

Wendy: it will be a small one

MRN: what are you here for

Wendy: a clinic, I don’t really know what for

MRN: you’re on my list, but I don’t have your file, are you here for a scan?

Wendy: could be, I don’t know

MRN: go to the end of the corridor, through the double doors and straight on, you’ll come to the scanning room

Wendy: *speechless*

MRN: *points* go to the end of the corridor, through the double doors and straight on, you’ll come to the scanning room

Wendy: I understand the directions, you want me to go to the scan room before we’ve found my file?

MRN: they probably have it

 

Scan Reception Nurse (SRN): I don’t have any file for you

The MRN bursts into the room breathing heavily and slightly dishevelled: Don’t worry, its my fault, I’ve found her file, it was very small

why are you here?
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NOT pregnant

Tuesday, November 29th, 2011 | tags: , ,  |

Nurse: Is that Mrs or Miss?

Wendy: that’s Dr.

Nurse: Oh! We don’t get many Doctor’s making appointments

Wendy: I’m not a medical Doctor, not eligible to bypass the normal NHS booking system

The Maternity Records Manager at Berkshire Royal Hospital followed my phone call with a written invitation to visit the Maternity ward. I have no history, aspiration, suspicion or risk of pregnancy

I can bring something, or someone, to entertain me. Lovely

bring a friend

NOT pregnant
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one choice

Friday, November 25th, 2011 | tags: , ,  |

My choices are – The Royal Berkshire Hospital!  Well that’s easy, I think I’ll use the Royal Berkshire Hospital.

Choose and Book. Not online

The NHS provides an awesome online ‘choose and book’ service for booking hospital appointments. Every patient is provided with a login. The Royal Berkshire Hospital foundation trust Gyneacology department doesn’t use this fabulous service.

I used my one choice and phoned the Royal Berkshire number

  • phone menu not working….
  • I called a different, direct, number. The nurse was unable to access the internal computer booking service. Helpfully, asked if she could phone me back after she’d rebooted her computer…

Several phone calls later I’d pinned down an appointment time with the consultant of my choice – on the NHS!  How do you choose your consultant? A tricky question for a non-specialist. All I could find was another public website, NHS choices, that provided me with all the staff names in the department, and  included ‘quality’ ratings as awarded by the hospital to their own staff.

one choice
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like 3 pints of good strong ale

Sunday, November 13th, 2011 | tags: ,  |

2 tablets had no discernable affect, on advice from the nurse I took  4 tablets. As I walked along the broad pathway to the Health Centre, I tried to walk in a straight line

Straight lines were not possible while under the influence. It felt just like walking home from the pub after a little too much to drink, but – without the pleasure of doing the actual drinking

Yep, I felt relaxed!

Drugs didn’t work – Normally I’m good with pain, not crying even when I break bones. This pain was worse. The nurse couldn’t bear my tears and screams. “I can’t do this” she said “you’d probably need a whole bottle of vodka before you could begin to tolerate this”.  A genius story to convert cries to giggles! My experience is rare, but does happen to others. I wonder why some ingenious inventor hasn’t already redesigned the equipment to make the process less painful for the few people like me

Hugs do work  – Afterwards I really wanted a dozen big hugs from tall empathetic people wearing cashmere jumpers with endless supplies of freshly laundered large white hankies. Unfortunately this treatment is not available on the NHS. Recruiting teams of  ‘huggers’ would immensley improve my experience

Refered to specialist – The GP’s refering me to a specialist who will do more detailed tests (MRI scans?). The specialist will then work out what treatment is right for me

I prefer some real ale’s in a pub with friends. Wouldn’t you?

like 3 pints of good strong ale
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relax, this will hurt

Friday, November 11th, 2011 | tags: , ,  |

wendy: I tend not to take pills, even when they’re prescribed. They gave me pain killers when I broke my arm, but I didn’t take them..

The doctor touches my leg again, this feels intrusive, but I’ll let it pass because I think he’s trying to be empathetic

Doctor: It’s going to hurt, you’ll need to relax so I’m prescribing these Diazepam pills to help you relax

I’m baffled, I’ve just told the doctor that I have a tendancy not to take pills yet he’s prescribing some

Wendy: the pills are to make me relax?

Doctor: Yes, it will hurt less if you’re relaxed, they’re quite strong so you shouldn’t drive after taking them

I nearly didn’t pick-up the prescription for Diazepam because I don’t want to take them. I’ll take them once and see what the experience is like. Maybe I’ll blog while I’m under the influence. Blog if I’m not so busy being chilled that I can’t be bothered. I discalim any responsibility for incoherence in my next blog post. I’ll be all drugged up

relax, this will hurt
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the ‘H’ word

Friday, October 21st, 2011 | tags: , , , ,  |

After each conversational turn he leant forward and touched my knee. I tried not to flinch at this intrusive, well-meant gesture. My coat still buttoned, legs and arms crossed against the cold of the unheated large Victorian parlour. Words like ‘hysterectomy’ conjur up strong images of knives and blood. To say that I flinched at the word would be an understatement. I fired the phrase NO INVASIVE SURGERY. My words ricochet around the uncarpetted consultation room. Not that the doctor was suggesting a hysterectomy, no,no, no, just raising my awareness of possibilities… …decisions come after a more thorough diagnosis. Diagnosis based on scans and tests conducted with grandly named ugly equipment referred to by, hopefully, obscure acronyms

My overreaction noted, he adjusted his conversational tone to include flattering my ego and being concerned. A good strategy for dealing with me

..there has to be a reason why and intelligent, mature woman like you….

He cited the evidence of my non-conformity to NHS quota filling activities. I felt like a school child being told-off for not having done their homework. It’s not a feeling I’m used to, I’m normally very keen to get my homwork done on time and to a a high standard. The last time I’d talked about this was 7 years ago, to my brother. His immediate reaction had been ‘cut it out!’. I was stunned at his eagreness to have me chopped-up when there wasn’t a convincing need for it. Surgery was just one option. I made a mental note – never delegate decisions about my health to my brother. Seven years ago, the USA health insurance paid-for doctor agreed the best way forward was my preferred choice of “lets wait and see“. Procrastination doesn’t come easily to me… except in this case… ….another new experience…

Now we’re having the “see” part, after 7 years of the “wait” part. I suspect the original doctor wouldn’t approve of a 7 year wait. But in all fairness to me, we hadn’t specified a time frame. I’m hoping the outcome will not be surgery and trying desperately not to overreact

Generally I’m failing

 

 

the ‘H’ word
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bring the broken arm in now

Monday, June 27th, 2011 | tags: , , , , ,  |

falling over

When I lived in the US my job provided comprehensive healthcare insurance. I fell over on a green slope while learning to ski. It felt like I’d broken my left, writing, arm. A friend drove me to the local hospital accident and trauma centre

It took 90 minutes to drive there, it felt like 90 minutes

checking in

 The centre’s foyer was like an empty hotel foyer, large tropical fish tank, carpetted floor, quiet with easy listening music playing. A lady in a blue suit sat at the large oak reception desk opposite the double, automatic doors. The lady asked me what was wrong, to see my insurance card, then gave me two paper forms to complete and explained that the financial adviser would see me in a minute. There was no sense of emergency about the situation. When you’ve just broken your arm, it hurts and your sensible thinking can go to pot. Maybe she didn’t hear me the first time so I repeat:

wendy: I think I’ve broken my arm, its the one I use to write with, the form probably wont be legible

receptionist: do your best

She didn’t look busy, she could have offered to complete the form on my behalf.  It fet impersonal, like my NHS experiences. Unlike the NHS, the environment screamed of wealth. I slowly filled out the form with my other hand, then waited

It was probably only five minutes later, but it felt like an hour…

Can we get money for this?

Please ring for attention Another lady in a business suit introduced herself and walked me into a side room where she photocopied my card and forms. She then filled in more paper forms on my behalf. I wanted to scream:

Where’s a doctor? I want to see a doctor! it feels like an elephants trampled on my arm

Clearly they needed these forms filling in and copying, my crying and screaming would just delay everything by making me incoherent and her difficult to hear. She took me back to the waiting room and reassured me that the doctor would be along soon. Pressumably they were flying in a doctor from another State

It was probably only five minutes later, but it felt like an hour…

Should we X-Ray the patient?

A lady in pristine blue lab coat introduced herself. Hooray! This must be the Doctor. She took me to a large room of empty trolley-beds and asked me to sit on one. She drew curtains around the bed, which felt weird because I wouldn’t need to take any clothes of and there was noone else in the room. Getting onto a trolley bed that is higher than your natural bum-height, with one arm, when you’re in shock and pain is not easy. She watched me struggle without offering help. It made me want to cry, but I wouldn’t be able to hear or answer her questions if I cried so I fought off the tears

The lady used a checksheet to ask me monotone questions… “no, I’m not likely to be pregnant …I giggled, a little light relief.  The X-ray nurse would be along to pick me up in a couple of minutes, when the x-rays had been developed I would see the Doctor

wendy: You’re not a doctor?

nurse: No, I’m a registered nurse

It was probably only five minutes later, but it felt like an hour…


Get the patient to the X-Ray machine

X-Ray DeptThe x-ray nurse turned-up with a wheelchair, repeated the questions the registered nurse had asked then offered me the wheelchair

Wendy: I’ve broken my arm not my leg

nurse: enjoy the ride

I felt bullied to conform to her expectation that I use the wheelchair. Asserting my preference to walk might lead to confrontation and cause tears, I wasn’t up to confrontation. She watched as I carefully slid from my trolley and moved into what looked like a racing wheelchair. 6 or 7 xrays later she unceremoniously dumped me back at the trolley. This time I stood instead of wriggling dangerously back onto the trolley. I suspect the hospital charged my insurance company for wheelchair and trolley rental – both unnecessary. As the nurse left I noticed the signs forbidding mobile phone use. My only entertainment device, forbidden

It was probably only five minutes later, but it felt like an hour…

Instruct the patient on proper behaviour

Freeway ExitA Doctor appeared! He glumly showed the x-rays while announcing that I’d broken an arm. I think he was disappointed by my lack of of surprise at the diagnosis because he went on to chide me for not having made it more obvious that my arm was broken.

Apprantly, saying “I think I’ve broken my arm” to the 4 people I was required to meet before him didn’t count as making it obvious that I had broken my arm.  He was quite clear about my poor performance as a patient, more crying was required.

I started crying about being reprimanded for failing to follow a hospital behavioural code that I didnt know existed.  The Doctor demonstrated his skill of ignoring tears while he prescribed earth-movingly strong pain killers and talked me through the treatment regime. I never took the pain killers. If he’d waited until I had stopped crying I could have asked him not to prescribe pain killers, not to charge my insurance company for them. But he wasn’t there to listen or understand. The Doctor was all about delivering instructions.

The lecture probably only took five minutes, it felt like 5 minutes of detention in the headteachers office…

Get reciepts and discharge the patient

mobile of deconstructed dictionaryChecking-out of the emergency room involved more form-signing,  another visit to the financial lady, and another visit to the receptionist

I’d collected an armful of paper forms at different stages in my visit. The discharge added yet more to the pile.  Each form decorated with my, new, right-handed signature

A spider dance

Next…

It felt like being gagged, prodded, and pushed along a clean and good-looking production line.  I was ‘the patient with insurance’ not wendy who believes that being aware of internal pain is mainly a good thing and  conversations will include critical misunderstandings if one party is crying and ignored 

If a miner incident like this is made distressing merely because the services are set-up to remove illness, not treat people – the prospect of a long term relationship with medical services becomes frightening.

Unlike people in the USA, at least I know that I will get some form of healthcare from the NHS whether I have an income or not

Scribble inspired by Nick’s post on how a desperate uninsured US man commited a crime to get healthcare provided by the prison service
bring the broken arm in now
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Your call is important to us…

Monday, August 8th, 2005 | tags: , ,  |

Rant warning

Like B******ks is my call important, to you personally,   your employer, or the company that contracted you. Throughput and money is important to the US Medical industry

Do I hear you ask “What’s up with our normally good humoured Wendy?”

Is ‘time of the month’ interferring with normal service?

Could be…   ..read on and judge for yourselves…

My Dr. suggested I take 3 Hospital based tests.    Urrggghhh.  3 separate forms.   3 different phone numbers to make appointments.    In 1 hospital,   1 building.   Each number took me to the same switchboard where I heard:

All of our  schedulers are helping other callers right now… your call will be answered in the order it was received… please hold the line…<beethoven>…

Each call took  about 15 minutes before a scheduler was free.   Schedulers don’t,   wont,    co-ordinate appointments within the building.    No  conference calling or call forwarding.    The last call ended with this unhelpful statement  ‘we can’t make an appointment for you because your Doctor hasn’t faxed us the appropriate form’.   They really couldn’t make the appointment on good faith and wait for the actual form to arrive.   They couldnt use details from my copy of the form,   held  tightly in my sweaty palm.    I could be trying to waste their time (money).   I’m not really their customer.   There is no clear business value for ‘good faith’ in such an impersonal system.

Patient centric? NO!

I phoned my Dr.

She’d wisely morphed into an answer machine.

I asked  the machine to  fax the forms to the scheduler  then phone me to confirm they were received so I can phone the hospital  & wait 15 minutes to make another appointment,   irritatingly  on a different day from the one I’ve successfully made.   <take deep breath>

Franz Kafka?   Modern US bureaucracy beats it all. An hour later after 4 phone calls  I only have 1 appointment and at least one more call to make. I’m upset & there isn’t even anything wrong with me.   Today I’m not even paranoid! I do cynically  believe a large proportion of  ‘tests’ are the medical  services  way to make money out of insurances…     …and people’s fears….

Why, why, why can’t medical services put the patient at the centre of the process…   one phone-call,   3 appointments sorted by an adequately staffed scheduling service who are thrilled about coordinating so that you only have to make  one trip to the Hospital & take only one afternoon off work.

It must be a nightmare for someone with a  genuine reason to be distressed before they even pick-up the phone…    ..to hear the unsubstantiated (insincere?) message of how important that call is to the Hospital…

Rant Over

 

Your call is important to us…
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