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April 2009

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Anne: 01.16.09 ER Trip

Last year, December 2007, I rushed myself to the hospital at UC Davis Med Center because a doctor at the clinic downtown told me I might have appendicitis. The week before I had blacked out (something I’d never done before) and I was damn near unable to walk. I waited almost 17 hours in an ER before anything was figured out. And at the time, it was like pulling teeth to get the woman I loved to sit by my side. I was under the impression at the time that I HAD to go to UCD to get medical assistance because I didn’t have medical coverage and the way the clinic doctor presented it made it sound like ONLY UCD would work with me. So I sat through the grueling hell that is the UC Davis ER for test after test. I was told at that time that I had Ulcerative Colitis. After a week’s stay I was discharged and put under the care of an Oncology doctor.


Throughout the next two months I was finally able to be seen by the doctors I needed to see, in Gastroenterology. I was told in February of 2008 that I had Crohn’s disease and was put on state medical disability. I’ve worked, straight pretty much, since I was 14, so for a Doctor to tell me I wasn’t ALLOWED to work was dramatic for me. But I followed doctors’ orders and just finished out my schooling. I graduated with my second bachelors degree in May of 2008 and have been on the interim ever since.


When I moved in October of 2008 (my THIRD move that year), paperwork got lost in the shuffle and even though I wrote a letter to CMISP (California Medically Indigent Services Program) stating that, without proper health care coverage, I was only destined to end up back in the hospital with another flare up of Crohn’s, they denied me coverage because the paperwork was late. So for the last few months I’ve been dealing with a chronic illness with no medication, no pain pills, and no coverage whatsoever.


Thursday, January 16th, I had simply handled enough. I went back to UCD ER because my attending physician belongs to the UCD Med Group and I want to continue seeing him, if at all possible. He knows my history. He knows what I want and don’t want. We’ve developed a working relationship that WORKS for the two of us. I sat in this ER for eleven hours. I watched paranoid schizophrenics walk around the ER dancing, clapping, and telling people that there were women giving birth in the bathroom and there was a man there waiting to rape the babies. And that all she needed was a shot of affection. I watched a woman there supporting a family member, knitting, with a sharp pair of scissors in her grocery bag. Only wondering to myself when the schizophrenic was going to lose it, steal the scissors and go on a rampage. I watched two women come into the waiting room from ambulances, and be forced to sit there. One woman came in just after me and was still there when I left. Thankfully I had two wonderful friends who sat there with me the entire time this time; deprived of food, showers, sleep, etc., the whole nine yards. They weren’t going to leave my side. There was no way they’d let me go it alone. That made this trip a bit more bearable than the one I had over a year ago.


But in the end I was triaged five times in my eleven hours. Each time the pain was getting progressively worse. I told three different triage nurses about the excruciating pain I was in. I told the last two that a new, burning sensation had developed in my colon, in the same area as I knew I had a perforation, and was still sent back to the waiting room. I gave up my faith in this ER when people who walked in after me, significantly after me, and who had no visible signs of pain or discomfort, were taken back to see doctors before I was. I left, with no pain management and no diagnosis, after sitting in the waiting room for eleven hours. And after the last triage nurse told me he was just going to check my vitals and send me back to the waiting room, disregarding the fact that I was balling tears of severe pain, and had a pain I had never felt before, I left. Broken and disenchanted with the medical community.


When I got home I got a phone call from SDI pretty much stating that my ONLY form of income was in jeopardy because one of the stipulations to receiving this money was to be in constant care from a doctor, and since she could see I had no current medical coverage she was pretty sure I wasn’t seeing a doctor. I told her I had been in the ER that morning and she pushed my check through. But this only forced me to have to go BACK to an ER so that I could hopefully get re-enrolled in CMISP and continue on my path with my doctor. But my dreams were shattered and I knew I couldn’t go back to UC Davis. So I packed myself up and went over to Sutter General Hospital.


I had signed in no longer than two minutes before I was called to “check in” and given the appropriate paperwork to initiate my CMISP application again. I wasn’t even able to finish the paperwork they required before I was brought back to triage for the first, AND ONLY, time. A bed miraculously happened to open up at that minute and I was in a bed in, literally, less than 10 minutes. I saw a doctor less than five minutes after that. And my RN, who had just started his shift and hadn’t even made all his rounds yet, was in my room in less than two minutes after that to start an IV and administer pain medication.  Within the hour I was prepped and moving down to Radiology for a CT Scan. Another friend arrived shortly thereafter to ensure that I was taken care of and brought home safely, after the pain meds were administered. Promptly about 30 minutes later the doctor was reviewing the results. He wanted to rule out appendicitis because of the new type of pain I had been having. I was in and out of this ER in a total of four hours; treated and tested, and given prescriptions to start my treatment again.


There was a drastic difference in the way I was treated in these two hospitals. At UCD I felt like merely a disease that no one wanted to treat. A disease, by the way, that is immunosuppressant, and merely sitting in the waiting room for so long could have lead to complications. At SGH I felt like a person WITH a disease. They treated me. They wanted to help me. They could see that I was in significant pain and they wanted to do EVERYTHING they could to help alleviate that.


I realize that UCD is the only trauma/shock/air rescue center from Fresno to the Oregon border. I also realize that they handle, directly, all the prisons and jails in Sacramento County. I realize they are a teaching hospital and because of that sometimes procedures take a little longer.  I realize that people need to be seen, supposedly, in order of severity and those that come in ambulances (usually) get priority. And I didn’t mind waiting – at least a little while. But it seems that every time I go to UCD I have AT LEAST a ten hour wait. My first visit there I thought I had appendicitis, and could have burst had that been true, in their waiting room. And they didn’t seem to care all too much.


Our health system is backwards and screwed up. At UCD I was put behind everyone else because I didn’t have medical. I realize they handle a lot but if they can’t properly staff and assist the general public, they shouldn’t be open to the general public. People go to ER’s for help. Because they need help they can’t WAIT to get from their primary physician. No one wants to wait but people would be willing to wait if they felt they were being adequately treated. I saw no fewer than 5 people (including myself) walk out of the UCD waiting room, hopefully to other hospitals, because their condition was so sever they COULDN’T wait any longer. No one should be denied medical care because they can’t afford it. No one should have to transfer themselves to another ER because they aren’t receiving treatment. No one should have their only source of income threatened because the same system that deemed them unable to work in the first place, is now denying them medical coverage that is needed and documented. No one should have to go through the pain of jumping through hoops to make ends meet, when they can’t even walk the stairs without being in pain.


Our system caters to the wealthy, the employed, and the healthy. Medical coverage is supposed to be designed to help those in need, those who have reason to see a doctor on a regular basis, not someone who has the common cold and can’t wait for a doctor’s appointment, or just needs a reason to get out of work, simply because they are employed and pay for the medical coverage. These systems are in place to help us live a longer, more satisfying life. Yet they take those of us who are at our lowest, and attempt to push us even further down. If, for some reason, my CMISP hadn't been approved, not only would I have been billed for the ER visit, but my SDI would have been revoked and I would have been forced to go back into the work force; something I don’t mind doing when I know my body can handle it. But until that time, I should have no fear of losing my income, my medical, my home, my life because our system doesn’t want to help me.


And yes, there are programs like COBRA in place to assist people without health care. But the basic COBRA package costs over $400 dollars a month, and when the state has deemed me able to live on less than $1000 a month, that medical coverage is more than I can handle. So, again, I can’t afford the proper coverage, and I’m pushed to the bottom of the list. I’m no longer even a chronic disease, I’m merely someone who can’t pay, and therefore doesn’t deserve treatment.


There are countries out there with Universal Health Care. I know that change is scary for us, especially in these economic times. But with a new President in office and the promise of CHANGE imminent in his presidency, it is about time that we got back to the fundamentals of life. We need to be able to give health care to everyone; regardless of race, culture, religion, sexual preference, or class. And sure, some procedures that are still “elective” should cost money. Something affordable. Something attainable for the general populous. These countries that have implemented these programs have happier citizens, healthier citizens, people who are willing to work and give and get back in return. Universal Health Care is not unattainable in our country. There is no reason someone should have to spend the night on the street because he or she doesn’t have a job, and possibly sit through the agonizing pain of an appendix bursting, or a heart attack, simply because they don’t have coverage. Who are we to decide who is worthy of living a healthy life and who isn’t? Who are we to play GOD with these people’s lives, and tell them because they have no money; they have no right to treatment, to live, to be happy? Why do we let ourselves die a slow death because the doctors are in the right pockets of most pharmaceutical companies that give them bonuses to write prescriptions that are unnecessary? And who are we to allow heads of medicine to deny treatment to someone simply because they have a quota to fill and the medical coverage denotes that they MUST deny a certain percentage of procedures yearly? Who decides who gets denied? And WHY in the world is NECESSARY treatment EVER denied?


Our country as a whole is only as healthy as is sickest individual. Because we cannot find a way to work together to make sure this person is happy, healthy, and whole, we will never be either. I should be able to walk into any hospital, any emergency room, and receive the SAME treatment based on my illness, not based on my financial ability to pay. As should every other citizen in this great nation. Our medical professionals go to school to save lives, to help people. Not to watch them wither away.


Please consider these things as President Obama takes office. Consider if you lost your job and were denied your cancer treatments, doomed to live out the rest of your days in pain and agony because you can’t pay. Health care reform is not a luxury, it’s a necessity.