Friday, June 22, 2012

Healthcare Follies, Part Two

 In this post I will chronicle my own personal journey through the Canadian and US healthcare systems with my recent heart surgery. Perhaps that will more clearly explain what you can expect if ObamaCare is not spiked by the Supreme Court with their decision next week.

Late last summer I noticed that I was getting out of breath walking up hills or even climbing stairs.  I was well aware that I had a flaky aortic heart valve.  Four or so years earlier when I had some work done on my knee, the “gas passer” in his pre-op exam, told me that sooner or later I was going to have to replace that valve.  I figured that time had arrived so I went to my family doctor in Whistler and he referred me to a specialist.  My appointment came back four months in the future.
Through the hunting season I was taking it slow.  Moose hunting at 5500-foot was not a sprint up the mountain and putting out the decoys a bit of a challenge.  I managed to land a 7-foot sturgeon without keeling over.  Finally, my appointment with the cardiologist came up on the calendar. (January 18.) For my legal protection let’s call him Dr. J.  He gave me a stress test and I flunked.  I checked into Vancouver General Hospital the very next day and they gave me the angiogram.
Turns out that in addition to the flaky valve I had some serious blockages in my coronary arteries (common among long term diabetics like me) and a triple by-pass was the major plan.  While they had my chest cracked they would give me a pig valve too. I would have to sit in the hospital until my surgery hit the top of the waiting list.  The average wait time, I was told, was two weeks but one poor fellow had already been sitting in the hospital waiting for a month.  You could be bumped at any time if someone showed up in worse shape than you.
I did not want to wait.  Once it was clear what needed to be done, I was anxious to get on with it.  Besides, sitting around twiddling my thumbs is torture for me.  My daughters and I were looking for alternatives for heart surgery in Bellingham and Seattle and I had accepted that heading south and paying cash was the way to go.  I needed my medical records to leave and my daughters fought through the bureaucracy at the hospital to get the required documents signed.  “Fine,” they said.  “We’ll send them to you in six weeks.”  That kinda put a kink in my plans to head south.
I don’t know if my threats to leave had anything to do with it (probably) but one week after my stress test I was headed to the operating room.  Nine hours later I had new plumbing and a dandy new valve.
Five days later and already coughing, they sent me home.  The coughing got lots worse and I was passing out because I couldn’t catch my breath.  I could feel the stress on my chest incision and my wired together sternum.  Loi drove me to VGH Emergency where we spent the day with me mostly laying on a gurney in the hall with dozens of other folks.  Finally they sent me home with more prescriptions.
The next week was Hell.  Fortunately, Loi kept notes because I don’t remember much of it.  I did not sleep much except in the recliner in the living room.  All night I would pace to keep the coughing at bay and when I had a “spell” I generally wound up passed out.  Early one morning I woke up to find myself lying in the middle of the living room.  No idea how hard I hit when I went down.
The only way I could communicate with Dr. J., my cardiologist, was via email.  I was begging him to take me seriously and do something.  I explained that I could feel the bones in my sternum moving around.  He was not concerned and his only suggestion was to move my appointment for the following week from the afternoon to the morning.  What a prince!
On the 9th of February.  I asked Loi to take me to Bellingham and St. Joseph’s Hospital.  They examined me and discovered that my chest cavity was half full of fluid and one of my sternum closure wires broken.  They sent me home.  (After this whole thing was over I pressed St. Joe’s to explain why they sent me home.  They explained that they had phoned my Canadian cardiologist, Dr. J., and he had told them he had it under control and was seeing me one week hence.  He suggested another cough syrup.)
That weekend was the worst yet.  No sleep, constant coughing and chest pain.  At one point I passed out and fell out of my chair. On Monday Loi drove me back to St. Joe’s Emergency.  This time they admitted me and Dr. Douglas, their head of cardiology,  came down for a look.  Xrays showed that my chest cavity was full of fluid and I had broken all three wires holding my sternum together and two of them had actually pulled right through the bone.  My incision had ruptured and fluid was running down my chest.  Infection was the big worry.
They sent me down to “Echo” where a doctor with a scary long needle went in through my back and started drawing fluid out of my chest, eventually getting 2.3 liters of juice.  My collapsed lung mostly re-inflated.  Dr. Douglas explained that they would have to crack my chest again and repair the damage but couldn’t do that until they got my chemistry sorted out.  Everything was a mess and it would be three days before they could get things under control and operate.
So, under the knife again only this time with big worries about infection.  They left tubes in my chest to drain and flush and a plug in my arm to pump me full of antibiotics.  I spent nine days in St. Joseph’s and for a couple of weeks afterward still had a thing in my arm where Loi pumped antibiotics into me twice a day.
Prior to the fix-it surgery I had told Dr. Douglas that if he successfully brought me through this that I would treat him to a round of golf and kiss his ass on the first tee.  He has yet to collect, although I am prepared to pay up at any time.  I am fine now.  Back to fishing and playing golf and making plans for travel with Loi.  She was a saint through all of this and it was probably more stress on her than me.

The lesson here is simple.  The original surgery was fine.  My Canadian surgeon did an excellent job.  The follow up care was where the screw-ups occurred. My cardiologist was incompetent or simply did not give a shit. I’m pretty sure it was the latter and if I had not taken the initiative and headed south, his inattention might well have killed me.

In my experience, Canadian hospitals are understaffed both in nurses and housekeeping personnel.  Hence, the nurses are stressed and the hospitals are not as clean as their American counterparts.  There are not enough doctors.  You cannot get a family doctor in south Vancouver.

Canadian health care is what you will get if ObamaCare becomes the US system.  Canadians hope it does not because they want someplace close to go when they really need quality care quickly. And, my liberal friends….. if you get ObamaCare you are going to hate it. 

1 comment:

Anonymous said...

You survived in spite of, not because of the medical services. I think you should move to Ridgefield. It's quiet and only a few minutes from Portland. Besides, if you two move here then maybe Karen, Kelly and the kids would consider relocating too! Stay healthy.