Wringing Out The Old Year

I wish!

There is so much about this last year I'd like to wring out of existence, not to  mention out of this next year. I won't deal with politics here since there is way too much to cover without writing a couple of books, and these postings tend to get long enough. Besides, I'd get too pissed off to hold on to any semblance of coherency. Or get to sleep tonight.

I'll stick to events closer to home. I'll likely still get pissed off, but with no chance of making a difference, the target of that anger becomes much more diffuse. Somehow that makes a difference in how much I fume myself into insomnia. No difference, don't be fooled, in how much I still care.

Let's start with justice. I personally know two people currently behind bars. One, simplifying the issues behind it, is for the crime of poverty. The original offense was enough to get into legal trouble, but that didn't lead to incarceration. What turned the key was the crime of poverty: if you can't afford the fine, behind bars you go. Another person has more than paid the debt to society by most any reasonable standard, but laws which could be more justly changed, not being popular issues, keep that door locked as well. Enough poverty to prevent hiring of a lawyer who actually is competent is a contributing factor there as well.

The other broad topic is poor health in people I care about. It's not that simple, however. I find myself furious and frustrated in the level and quality of healthcare available, even when it appears to be provided and mostly paid for.

Let's start with a "young" friend of mine. "Young" in this case means early 40's. She has been fighting MRSA for perhaps a dozen years by now. It has cost her two surgeries to remove pieces of a foot, has prevented her having a functional and pain-free ankle even after two bone graft surgeries, and has now invaded her jaw. They are beginning to discuss surgery options to her face now, with who knows what results. What makes me angriest is how antibiotics have (not so well) been administered. Her primary care doc has been the same over this period, so has no excuse for being unfamiliar with her MRSA history. Yet each time another infection got under way, it was treated with the typical 10-day program of mild broad spectrum antibiotics followed by a pause, and reassessment only after symptoms flared up again in a few days. Then followed a repeat of the same, finally followed by the good stuff, which managed to knock out the overt symptoms. Testing to identify the MRSA didn't occur until partway through the 2nd course, though her history alone should have made that a top-of-the-list suspect after the first time. The result of all this is that the MRSA found itself a spot in her body to tuck away until next time it got the opportunity to strike. Each recurrence seems to have produced a hardier strain to attack her, the logical result of chronic under-treatment.

I wonder what they can do this time with surgery, since they normally don't operate while a fever rages, but they need to remove infected bone to get rid of the most recent pocket of infection.

The other medical situation causing rage against a medical team revolves around Steve. Those who keep in touch are aware that his back has been plaguing him for weeks now. He has had problems in the lumbar region every few years, usually lasting a few days and fixable by lying on the floor in a certain position. We thought when this time started, it would follow the same pattern. It's been over a month now, gained him a higher strength prescription for pain medication and one for muscle relaxant. Despite medications he's dealing with intractable severe pain without relief. Sleep is scarce. Activity is limited to the point where he won't go out on his scooter because there are little bumps in the surface over which he travels. His card clubs, one of the  main recreational/social parts of his life, simply don't happen. He is getting severe cabin fever, since his main travel is to the doctor about a mile away. He moves from his lift chair to bed and back, not to mark wake/sleep cycles, but just to change position enough so something else hurts, and hopefully not as much for a bit. On the 1 to 10 pain scale, 5 is a good hour, and 9 more constant.

So, the anger? It took about 2 weeks for an x-ray. Indeterminate. A shot into his hip yielded pain relief... for two days. Another two weeks wait yielded an MRI. One more week got an interpretation of it. Two lumbar vertebrae are growing, both together and into the cord. (Is it an improvement to get the affirmation that it's not just in your head?) One possible cause is rheumatoid arthritis, and a blood sample was drawn. Two referrals were to be made, one to follow up, if the blood test is positive, on treatment for what is an autoimmune condition. The other was to be with a spinal orthopedic expert, who might expertly administer pain injections into the spinal column, or perhaps offer a surgical option.

I talk about referrals needing to be made. That's about insurance rules. The specialists, or even the x-rays and MRIs, need to be ordered by the primary physician. They also need to be to one of the medical clinics that accept the insurance he carries. We left the office that day confident that those would be made.

That was over two weeks ago now. You know where this is leading. We were shocked about why. When the next Monday rolled around with nothing heard about his referrals, he called in to his Doc. Maybe a little reminder of how badly he needed to get treatment would push the right buttons. Instead, the answering service informed him that the entire office had closed for two weeks for their holiday break. Try the ER, good-bye. Nobody had bothered to mention this when we were in the office getting his test results and treatment plan options.

Steve opted not to hit the Er, but tough it out if at all possible. Rather than take medications only when the pain was at its absolute worst, not wanting to risk either habituation or addiction, he is dosing himself in the meantime with whatever either medication allows, alternating them rather than overlapping them. His body is still getting to the point where it can ignore either one of them.

Wednesday the clinic reopens. With no appointment, I've promised to drive Steve over so he can demand as much attention from the staff as needed to get those referrals then and there. I even offered to help, quite willing to let the other waiting patients know of the inadequate level of care offered there.

Enough is way too much. I'm almost looking forward to it. 2018 needs to be history.