I wanted to write a little bit about how insane Ann Coulter is, but I think I'll leave it to all the others who are doing a great job: Glynnis MacNicol from Business Insider and Frances Martel from Mediaite featured on Talking Points Memo. Onward, to my next official blog post which hasn't happened since...crap, since I posted my last quickie for a class last semester.
This edition of Health care from a patient's perspective is going to focus on what happened when I tried to get insulin here in Hawaii. I gotta tell ya, my Weird Shitometer went batshit crazy. Here's the deal:
Last semester I didn't have health insurance...in fact, I didn't have health insurance from July 2010 until last week. I do feel lucky, in that calling up the health insurance folks who enroll us Instructors in the plans did move things along extremely fast, so thank you HMSA/EUTF employee I spoke with last week. Back to reality: I was running rully, rully low on 'slin. For those of you who know what I'm talkin bout, that ain't good. I saw my doc on campus, which cost me $20...doesn't seem like much, but hey, I was broke-ish. My bottle of Humalog was gonna cost me almost $150, and I'm grateful to my girlfriend who covered it for me at the time. Really grateful; I think I still owe her a couple foot massages.
After seeing the doc, I got my script, and headed to Walgreens here in Honolulu. As I was trying to pick up the insulin the first time, I started getting weird questions.
Pharmacy tech: "This doesn't say how much you're supposed to take per day."
My reply: "yes it does; it says I have an Insulin pump for a basal, and to take boluses by sliding scale with meals as needed...it changes based on how many carbs I'm eating, my exercise/activity, other factors..."
Pharma: "no, that won't work. We need to have specific directions otherwise we can't give you this lifesaving health product that you won't survive without. Sorry. Better luck tomorrow when the doctor's office opens and we can confirm."
Me: "uhh...ok? What's the deal, yo? I've never heard of this kind of weirdness before."
Pharma: "It's Hawaii law, so we can't get sued if you overdose."
Me: "Really? Is this state this weird? I've had diabetes for two decades, I'm in great shape and I'm really healthy. I think I'm capable."
Pharm: "Sorry, can't do it. We have to know that you know what you're doing."
Me: "20 years as a diabetic. Seriously. If I fuck up my own diabetes care, what am I suing you for? Irresponsible pharmaceutical activities? Slangin the wrong 'slin to a shady character such as myself?"
Pharm: "We'll call their office tomorrow, and we'll see you after."
Me: "Right on. I know this isn't your fault, but I'd love to know what the background is..."
So that's my Hawaii diabetes weirdness that sent my Weird Shitometer off the scales. Anyone else seen something funky like this?
Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts
Thursday, February 3, 2011
Saturday, September 25, 2010
The first 'medicine from a patient's perspective'
Medicine in the United States is a complicated beast, mainly because of the differences in experience between professionals and patients. Not only that, but different professionals have different experiences within the context of working in medicine. (i.e. Nurses compared to practicing M.D.'s) That being said, I've decided to write this blog about medicine from the patient's perspective.
When you enter a hospital, say for a "routine appointment," you can never be sure you know what's going to happen. Also, having "routine appointments" assumes a great many things: you have health insurance or are substantially well off financially, you have a regular doctor to see that you like enough or trust enough to keep seeing, that you understand the potential consequences of not engaging in preventative medical care, ad infinitum. So with these things in mind, let's continue.
You've entered the hospital, and you're heading up to wherever your doctor's office is. There are sick people all over the place (which is appropriate given where you are) and medical pro's running around. Your heart rate starts creeping up, just with the almost palpable adrenaline levels creeping through the halls. You get to where you're going, and a receptionist more often than not says something like, "hi, welcome! Please sign in and we'll get to you as soon as we can." Most of the time, these folks are either professional receptionists, or nurses which kinda ticks me off because nurses have a ton of stuff to do already, but that's another post. You take a seat alongside the other waiting folks, and sometimes there are some sickies, sometimes you're practically alone. Depending on what kind of facility you're in, this could be consistent one way or the other.
Sometimes almost immediately you are called back, sometimes it takes an hour or less. The first nurse who leads you back into the shiny and band-aid scented exam area has you step on a scale emotionlessly, reads off your blood pressure, asks some general questions including, "why are you visiting us today?" Like 'visiting' really does it justice, but it can be comforting. You answer as best you can, and after a few minutes the nurse asks you to wait for the doc. This waiting period is terrible. You never know if the nurse is quickly meeting with said doc about how much you suck given your weight, blood pressure and habits you've briefly discussed with him/her, and whether they're planning to bust into the room shouting, "what the hell is wrong with you! You're gonna die!" Or perhaps the doctor is just finishing up with the two patients who went in before you did. Who knows, it's a mystery for the ages. There are only so many times you can re-read the "how to recognize suicide in yourself and your friends" pamphlet. Just saying, maybe some reading material in the treatment rooms?
The doc comes into the room. Usually they have an agenda based on their previous visit notes, and your current "situation," you know, the weight/bp/lifestyle stuff the nurse got outta you. The going assumption seems to be that docs don't care, but they have to have a game plan if they're going to get you to keep yourself alive, let alone get through the appointments and walk-ins they've had and will have during the day. The conversation is sometimes give-and-take, sometimes lecture (better take notes), and sometimes a mix of those two plus a visit from someone else on the team, say a dietician, or social worker. Then you're out, with a few pamphlets and some homework.
There are different places that do this in ways that feel better or worse than others. Some places are purely overloaded, and some places have a lot of money with which to actually hire enough medical and pro-staff. The differences can be striking. I've always been privileged to be able to find endocrinologist offices that actually serve as my primary source of medical care. I say this because when you're working full time and sometimes also part time, go to school and have a semblance of a life, there aren't enough hours in a business day to see more than one medical team. That's reality. It's also a very privileged and lucky reality and I know it. Here's where we find some disconnect: patient responsibility vs. medical responsibility.
Patients, we gotta do our part. There is no "wellness pill." There is no magical potion, no quick fix, no seemingly easy answer. You want that, go see an expensive and ultimately fucked up practioner of elective cosmetic surgical procedures. Not only will you be able to pay someone to look a certain way (assuming you have a ton of cash to burn), but you also will still die unhealthy. Good luck. We as patients have to do everything we can to keep ourselves together. It's a long process, and it's worth it as nurseXY is finding out and with good reason. (Keep up the good work bro.) And, the more you do for yourself, the better this doctor/nurse/patient relationship will be. Ask questions, no matter if you feel stupid. Get the information. Medical pro's can't know what you need unless you tell them, and it's impossible to always find the most important stuff online. Again, quick fixes can backfire big-time.
However, to all the medical pro's: we aren't all idiots. Some of us are, and I can't speak for them. They're jackasses, and they're suffering even as they suck. But some of us do care, not just about ourselves but about other people. Know that the intimidation we feel when our medical pro asks us, "any questions?" is real. We don't want to look stupid, even though you probably will be more than willing to either answer, tell us where to get the answer or have someone on the team help us. But it's not easy for many of us to feel comfortable. You're behind an opaque wall of mystery, and this means we're not always going to be willing to not only ask, but demand we be treated with respect and understanding.
This two-way street is remarkable in that there are so many twists, turns, and misunderstanding abound. And with medical care reform being not only futuristic, but incompatible with medicine as a business, we're in a perpetual state of denial about what our huge system really needs in order to function at a level that means we're successful on a broad scale.
The next installment will be 'the patients' perspective in a capitalistic medical market.' Hope y'all enjoy, or start talking.
Cheers,
-Street Philosopher
When you enter a hospital, say for a "routine appointment," you can never be sure you know what's going to happen. Also, having "routine appointments" assumes a great many things: you have health insurance or are substantially well off financially, you have a regular doctor to see that you like enough or trust enough to keep seeing, that you understand the potential consequences of not engaging in preventative medical care, ad infinitum. So with these things in mind, let's continue.
You've entered the hospital, and you're heading up to wherever your doctor's office is. There are sick people all over the place (which is appropriate given where you are) and medical pro's running around. Your heart rate starts creeping up, just with the almost palpable adrenaline levels creeping through the halls. You get to where you're going, and a receptionist more often than not says something like, "hi, welcome! Please sign in and we'll get to you as soon as we can." Most of the time, these folks are either professional receptionists, or nurses which kinda ticks me off because nurses have a ton of stuff to do already, but that's another post. You take a seat alongside the other waiting folks, and sometimes there are some sickies, sometimes you're practically alone. Depending on what kind of facility you're in, this could be consistent one way or the other.
Sometimes almost immediately you are called back, sometimes it takes an hour or less. The first nurse who leads you back into the shiny and band-aid scented exam area has you step on a scale emotionlessly, reads off your blood pressure, asks some general questions including, "why are you visiting us today?" Like 'visiting' really does it justice, but it can be comforting. You answer as best you can, and after a few minutes the nurse asks you to wait for the doc. This waiting period is terrible. You never know if the nurse is quickly meeting with said doc about how much you suck given your weight, blood pressure and habits you've briefly discussed with him/her, and whether they're planning to bust into the room shouting, "what the hell is wrong with you! You're gonna die!" Or perhaps the doctor is just finishing up with the two patients who went in before you did. Who knows, it's a mystery for the ages. There are only so many times you can re-read the "how to recognize suicide in yourself and your friends" pamphlet. Just saying, maybe some reading material in the treatment rooms?
The doc comes into the room. Usually they have an agenda based on their previous visit notes, and your current "situation," you know, the weight/bp/lifestyle stuff the nurse got outta you. The going assumption seems to be that docs don't care, but they have to have a game plan if they're going to get you to keep yourself alive, let alone get through the appointments and walk-ins they've had and will have during the day. The conversation is sometimes give-and-take, sometimes lecture (better take notes), and sometimes a mix of those two plus a visit from someone else on the team, say a dietician, or social worker. Then you're out, with a few pamphlets and some homework.
There are different places that do this in ways that feel better or worse than others. Some places are purely overloaded, and some places have a lot of money with which to actually hire enough medical and pro-staff. The differences can be striking. I've always been privileged to be able to find endocrinologist offices that actually serve as my primary source of medical care. I say this because when you're working full time and sometimes also part time, go to school and have a semblance of a life, there aren't enough hours in a business day to see more than one medical team. That's reality. It's also a very privileged and lucky reality and I know it. Here's where we find some disconnect: patient responsibility vs. medical responsibility.
Patients, we gotta do our part. There is no "wellness pill." There is no magical potion, no quick fix, no seemingly easy answer. You want that, go see an expensive and ultimately fucked up practioner of elective cosmetic surgical procedures. Not only will you be able to pay someone to look a certain way (assuming you have a ton of cash to burn), but you also will still die unhealthy. Good luck. We as patients have to do everything we can to keep ourselves together. It's a long process, and it's worth it as nurseXY is finding out and with good reason. (Keep up the good work bro.) And, the more you do for yourself, the better this doctor/nurse/patient relationship will be. Ask questions, no matter if you feel stupid. Get the information. Medical pro's can't know what you need unless you tell them, and it's impossible to always find the most important stuff online. Again, quick fixes can backfire big-time.
However, to all the medical pro's: we aren't all idiots. Some of us are, and I can't speak for them. They're jackasses, and they're suffering even as they suck. But some of us do care, not just about ourselves but about other people. Know that the intimidation we feel when our medical pro asks us, "any questions?" is real. We don't want to look stupid, even though you probably will be more than willing to either answer, tell us where to get the answer or have someone on the team help us. But it's not easy for many of us to feel comfortable. You're behind an opaque wall of mystery, and this means we're not always going to be willing to not only ask, but demand we be treated with respect and understanding.
This two-way street is remarkable in that there are so many twists, turns, and misunderstanding abound. And with medical care reform being not only futuristic, but incompatible with medicine as a business, we're in a perpetual state of denial about what our huge system really needs in order to function at a level that means we're successful on a broad scale.
The next installment will be 'the patients' perspective in a capitalistic medical market.' Hope y'all enjoy, or start talking.
Cheers,
-Street Philosopher
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