Posts Tagged 'healthcare'

The dangers of “Fight Club”… someone might actually break a spine?

Ok, so it has been some time since I last posted on Broken Spines but it is with good reason.  Just over ten weeks ago I actually broke my spine… I woke up to sure agony.  I thought I had pulled a muscle in my neck/back and waited it out over night.  The next morning the pain was still there and I made an appointment to see my doctor and a chiropractor and a colleagues suggestion.  The chiropractor proceeded to tell me how messed up my neck/back was and gave me an alignment adjustment with no improvement.  My doctor saw me and thought that it was a pulled muscle and prescribed muscle relaxers and Vicodin.  After a week on the drugs, more chiropractic “help” and even acupuncture I was without sleep and still in excruciating pain (so much so that on some nights I honestly would have preferred amputation).  Talking with friends and colleagues I was convinced that I needed to see a specialist.  I called the recommended neck & back specialist the next morning and was told that I needed a referral from my primary doctor and an MRI before the he would see me.  I  called my primary doctor and after some pleading I was able to get an appointment the next day.  My doctor ordered x-rays, did an exam, and agreed to give me the referral and MRI request.  At the scheduling area for the MRI I was told that there was a mobile unit that came to the clinic on Mondays and Thursdays… and of course today was Tuesday – I had to make it clear to the scheduler that Thursday was not soon enough.  Sure enough there was one at a local hospital and their MRI was available that evening.  After the most painful 30 minutes in an MRI machine I get to go home and wait until the next morning for the results.  In the meantime, I called the specialist back and told his staff that I my referral and my MRI – how soon could they get me in?  The answer – three weeks!  I wasn’t going to last three more weeks with this pain and lack of sleep!  I explained that to the scheduler and she suggested that I leave a message with the doctor’s assistant and they would get back to me.  I decided to pull out all of the stops and left the voicemail informing them that my neighbor worked with the specialist, two other neighbors had seen the doctor and one had surgery with him, and that I was in EXCRUCIATING pain.  What do you know… they found room for me within seven days.  The next morning the MRI report was available online and I come to find out that I had herniated a disc in my neck/spine: C6-C7.  I meet with the specialist the next week and after three weeks of the most excruciating pain I have ever felt (even with the aid of the finest narcotics man has made) I was finally prescribed oral steroids (a.k.a. Prednisone).  Within hours the amazing anti-inflammatory medicine in Prednisone had started kicking in and the pain was almost gone.  The only lingering effect was numbness or tingling in my first two fingers of the my left arm.  I proceeded with six weeks of physical therapy which helped strengthen my neck and arm but still left the numbness.  The only problem now was the persistent numbness… my specialist suggested that I did not want it to go beyond 12 weeks or I could risk permanent nerve damage.  Last week was week 10 and I decided to proceed with surgery to remove the herniated portion of the disc that was causing the pressure on the nerve (posterior microdiscectomy)… five days in and still waiting for a final verdict if the numbness has gone away for good.  I’ll keep you posted…

Narcissus Pining for His Own Image

Roger Cohen has an interesting perspective on the healthcare debate. He writes that we’re all so wrapped up in our own lives, what he calls “frenzied individualism,” that we can’t come together to accomplish what is in our own best interests, namely fixing healthcare. He points us to Alain Ehrenberg, a French author and psychologist, whose new book “The Malaise Society” (with apologies to President Carter) makes the case that Western culture is afflicted by a narcissistic neurosis.

He quotes a friend of his who makes the most succinct argument for a public option that I’ve heard yet:

When it comes to health it makes sense to involve government, which is accountable to the people, rather than corporations, which are accountable to shareholders.

Narcissus by Caravaggio

Rational Debate re: Healthcare

I love this YouTube clip of Sen. Franken discussing healthcare with his constituents for several reasons: 1) it’s at the “great Minnesota get together” – the State Fair 2) a few of his constituents in the frame clearly didn’t vote for him (TEA Party) – but are thoughtful, considerate and listened to what he had to say 3) what Sen. Franken had to say was sensible and well articulated. I’m glad he’s my Senator and I’m glad I live in Minnesota.

Socialized Fire Fighting

I’m getting frustrated as I read reports that Obama’s health plan “has gone astray.” I don’t understand why Americans are afraid of increased government involvement in healthcare. It’s working well for the VA and Medicare – and isn’t the profit motive misplaced in healthcare anyhow?

In his column this morning, Nicholas Kristof writes:

…we have a single-payer system of public fire departments. We have the same for policing. If the security guard business were as powerful as the health insurance industry, then it would be denouncing “government takeovers” and “socialized police work.”

I just don’t understand why we may be about to reject health reform and stick with a dysfunctional system that takes away the health coverage of hard-working Americans when they become too sick with cancer to work.

McAllen, Texas and the Overuse of Medicine

Atul Gawande is a surgeon at Brigham and Women’s Hospital in Boston and a talented writer.  Last week the New Yorker published an essay of his, The Cost Conundrum, about how McAllen, Texas is the most expensive healthcare market in the US (and probably the world).  Granted people are not very healthy in McAllen.  So, he compared McAllen’s average of $15,000 per person to nearby, and equally unhealthy, El Paso … costs were almost exactly half of McAllen, $7,504 to say nothing of quality or outcomes (for the highest quality outcomes we turn to Mayo Clinic, in our fair state, which costs an average of $6,688).  So, why are costs in McAllen twice what they are elsewhere?  Simply put: overuse of medicine.  Gawande explains that doctors are compensated not on quality of their care rather quantity:

Between 2001 and 2005, critically ill Medicare patients received almost fifty per cent more specialist visits in McAllen than in El Paso, and were two-thirds more likely to see ten or more specialists in a six-month period. In 2005 and 2006, patients in McAllen received twenty per cent more abdominal ultrasounds, thirty per cent more bone-density studies, sixty per cent more stress tests with echocardiography, two hundred per cent more nerve-conduction studies to diagnose carpal-tunnel syndrome, and five hundred and fifty per cent more urine-flow studies to diagnose prostate troubles. They received one-fifth to two-thirds more gallbladder operations, knee replacements, breast biopsies, and bladder scopes. They also received two to three times as many pacemakers, implantable defibrillators, cardiac-bypass operations, carotid endarterectomies, and coronary-artery stents. And Medicare paid for five times as many home-nurse visits. The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine.

Apparently, Obama has made this mandatory reading for his staff.  If we could reign in places like McAllen, Medicare could save 30%.


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