Posted by: joha5 | September 23, 2010

Health Hazards: Illness, Money, and Making the Right Decisions

I breathe like a pug with bad allergies.  In fact, it is even worse than that.  My right nostril is totally inoperable, my sinus cavities feel so swollen that they could burst at the slightest touch, and it looks like I am constantly out of breath because I am being forced to breathe out of my mouth.  Most of the time I am not, however.  I don’t know when or how this whole saga began but all I know is that I want it to end.

And ending it is what I am attempting to do right now – albeit after being made to jump through a number of hoops with bells and whistles on.  At the moment I feel like I am puppet of the healthcare system – or whatever system we currently employ in the United States.  Who can really say anymore?  Needless to say I want my face to be fixed and I want it to be fixed now.  But this isn’t the way life works.  There is a process that I must adhere to before anything can be done.

If a picture is worth a thousand words then this picture perfectly encapsulates the way I breathe at the moment.

I went to the Ear, Nose, and Throat doctor just over three weeks ago with a litany of ailments that I will not detail here due to the sensitive stomachs of some of my readers.  The doctor administered some tests which mostly included him sticking a tiny swab of cotton at the end of a long wire into my facial orifices.  This was not comfortable.  But I knew I had to think long-term rather than short-term.  I complied with these tests and told him that they ‘weren’t as bad as I had thought they would be’ when in fact they were worse.  It’s a weird feeling when you realize there are neuron receptors on parts of your body that nobody has ever touched before.  After a 45 minute appointment I left with a bag full of prescriptions, nasal cleansers and rinses, and instructions of what to do next.

On the way home I filled my prescription for a steroid treatment that would reduce some sort of facial swelling.  I began taking it immediately but the results only started to occur a couple of days later.  But when they did – My God! – did it work.  Over the next 12 days I slowly returned to feeling like the top prize winner at the Westminster Dog Show rather than a mixed breed bastard of a pug that I had become.  This treatment, however, came at a price.  My sleep would be restless and unfulfilling and I would lie awake tossing and turning while every little sound felt like it was amplified to a triple digit decibel level.  I would also put on weight.  5 pounds in 12 days.  And no, this is not because I am fat or because I was ravenous or because the drugs made me over eat.  This is apparently a side effect of steroids.  At least I didn’t get the back acne.

A week later I went to the hospital to get a Computerized Tomography which is also known as a CT Scan.  This seemed excessive but again, as long as I was on the way to getting better I just didn’t care.  If you have never had one of these things done it is actually quite intimidating.  I was placed on a table like a very expensive piece of meat, covered with a lead jacket, and told to lie very still.  All of a sudden a cylinder began whirring behind me, the table raised, and the inside of my head was being scanned by this contraption.  I thought it was paradoxical when they told me not to move because moving is instinctually the last thing you feel like doing when a multi-million dollar machine begins to look inside your skull.  If the process involved not moving while they threw frisbees at my head or something then I could see the value in telling me not to move.  But getting a ‘computerized tomography’ does not inspire me to thrash around on a table.  Luckily, five minutes later, the scanner slowed down and turned off.  The table lowered.  I was dismissed.

This is a very romanticized picture of a CT Scan. I may as well be saying 'Beam me up, Scotty!'

It took about 4 days for me to get the results and they involved terms that only physicians would understand.  The only things that I understood on the results sheet was ‘deviated septum’, ‘severe pain’, ‘surgery’, ‘sinus’, and ‘death’.  Okay, death wasn’t actually on there but it may as well have been.  Seeing the word ‘severe’ attached to anything does not inspire confidence.  But there was still another part of the process that needed to be completed.  The polysomnogram.

The polysomnogram is a sleep test.  For those of you who do not know what a sleep test is, let me explain it to you in layman’s terms.  A sleep test is when your entire head gets covered with electrodes.  As if this wasn’t bad – or embarrassing – enough, they also attach some to your throat, your chest, your hand, and your legs.  They plug you into this futuristic looking box attached to the headboard, wrap a belt around your chest and your waist, and tell you to sleep well.  Seriously.  Oh, did I forget to mention that they have an infrared camera in the ceiling watching you while you sleep and that they take notes on everything that happens.  You try getting a good night of sleep in an environment like that.  I certainly hope they considered this flaw when they were in the development process of this experiment.  I only got a small glimpse of myself when I went to the bathroom – and I had to call the guy in to let me out of the bed – and it looked like I was on life support after being hit by a car only without the blood, the bruising, and the scarring over my body.  I had pipes in my nose, tape and glue all over my head and face and I smelled of rubbing alcohol from head to toe (not that I could smell it).  I probably got to sleep around 11:30pm or so and was awakened at 5am after an anticipated rough night of sleep.  I then had to be unattached from the bed. 

This is a picture of me when I woke up the morning after my Sleep Study. Do you like my dinosaur pajamas?!

This process was much quicker than the attachment ceremony that I had gone through the night before but it also consisted of a lot more rubbing alcohol and a lot more ripping.  The tape was ripped from my hands and arms.  A layer of skin went with it.  More tape was ripped from my neck and face and hair and more of my body went with it.  And then the worst part: my legs.  I don’t have much leg hair and the hair that I have is blond and precious.  There were 2 electrodes on either leg.  I knew I was in for a treat.  The polysomnographist – or whatever it is they like to be called – began tearing at my legs like a jackal on a fresh carcass and it felt even worse than that.  I could barely bring myself to look at what he had done but when I looked in the trash I could see my beautiful blond leg hairs all over the sticky side of the tape that held the electrodes in place.  I looked down at my legs.  The areas were bright red, they were hairless, and it stung.  Oh, and they had left a tiny patch of hair in the middle as well where the electrode was touching my skin.  I now had 4 donut marks on my legs.  Luckily none of the kids that I teach have noticed these crop circles on my legs yet but I can only imagination the condemnation and whispering that will go on behind my back when they do. 

So that brings me to today.  Here I am.  Still breathing like a pug and panting like a labrador.  I suppose there is much more information out there on me so I just have to wait for the medical industry to collate all of this information so they can finally tell me that I can get surgery to fix my septum and any other problems that they find.  But I can’t help but feel as though everything is still kind of the same only the doctors are richer and my insurance company must be wondering what the hell is wrong with me (not that they care at all).  It has now been almost a month since this procedure got underway and I am all for partaking in a safe and healthy process of diagnosis but I can’t help but be frustrated.  Did I really need to take a sleep test if they know my nose is completely inoperable?  Did I really need the steroids?  Why didn’t I just get the CT Scan initially and then go back to the doctor to see what he could glean from the information?  Information is a great tool in deciding these things but sometimes too much information can be a hinderance rather than a benefit.  I have never – nor will I most likely ever – take the Hippocratic Oath so I am certainly not second guessing my doctors.  What I am second guessing is the necessity of some of these tests especially considering that our healthcare system has a number of financial incentives rather than incentives for limited spending and efficiency. 

I fully expect that I will get surgery in the next 6 weeks to fix my septum and the doctor even said so within the first 10 minutes of my meeting with him.  Said the doctor: ‘I simply cannot say right now whether or not you need surgery but I will say that I have sent a number of patients in to the O.R. for less than what you have.  I just need to get more information before I make a final decision.’

If my problem was that severe I just wonder why he didn’t make the decision and gone with what he saw initially.  That way I wouldn’t be struggling with this nagging problem almost a month later.  But then again, that way wouldn’t be getting him another appointment or two with me to discuss the process and that way wouldn’t have earned him as much money. 

Where is the line between Business and Healthcare? Nobody really knows.

I know this sounds quite controversial but in the end I am in favor of him having more information to work with than less and I don’t regret taking all of these tests and going through the process.  I just wish I knew more so I could take more and better control of decisions of my own health than leave it completely up to somebody else. 

Oh, by the way, I have to have another polysomnogram done this coming Monday. It will be exactly the same as the previous one only this time I have to have a CPAP test done (essentially wear a breathing mask while I sleep).  After all of these tests taken so far, will it really have an effect on my doctors final decision?  I say probably not but it doesn’t matter what I say because I am fully aware that I will never truly know the real answer.  All I know is that I am still breathing like a mixed breed bastard of a pug and I want it fixed.  Now.

~~~~~~~~~~~~~~~~~~~~

Post Script: I received my results today for my sleep test and was informed that following my CPAP test this coming Monday that I would then be required to order a breathing machine – it would be covered by insurance apparently – and sleep with a facemask for a one month period.  I would then be required to go into the Sleep Test Center again to discuss the data collected over the month and it would then be decided if this should be a permanent fix to the ‘sleeping problems’ I didn’t even know that I had and if this should be a lifelong process.  Needless to say, I promptly called the Sleep Center to postpone this appointment indefinitely until I spoke with my doctor about the neccessity of this process.  They were not pleased with this turn of events for obvious financial incentives but I didn’t care.  I’m just pleased that I was able to make the cancellation deadline for the appointment.  Otherwise they would have charged me $150 out-of-pocket.  There are many things that I can think of that would improve our healthcare system but one stands out more than any other to me.  I just wish the line between health and business wasn’t so blurred so that I could be absolutely sure my health was the number one priority 100% of the time.  But then again, maybe that is asking too much.   

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