Health is a fragile state. Fragility insulated by a ‘health’/’sick’ care ‘system’. Systems are innately fraught with failure and loop holes that create more problems than they solve.
It is currently the week before Christmas but I am going to ask you to look back to the end of summer or September. Ranching is an active family life, no one sits around and everyone pitches in. Sitting still is laden with guilt while others frequently work 12 plus hour days. It is the life I was raised in and still frequently exist in. My mother is an overactive 60 year old grandmother. She is the primary care for a 4 and 7 year old. She is the chief chef, house keeper, book keeper, brains and hired man for my brother who is now running the family business. She has had cancer twice and has been in remission since 2007 living with a colostomy that many family members and neighbors were unaware of until this September.
It was a gorgeous ‘normal’ day and mom was working outside on her house and in her garden. She thought she pulled a muscle. A red and hard spot developed close to her colostomy and she was waylaid by a fever and fatigue. This sent up a red flag, a BIG one. Pulled muscles do not result in fevers. I have had experience in caring for patients with colon problems that resulted from colon contents escaping into the body cavities instead of the toilet. Bowel contents are extremely toxic to the body and when they escape this way they create a condition called sepsis or blood poisoning if you look in antique medical books. I demanded that my mother make a doctors appointment. She did and he was unconcerned, later he said he never knew about the fevers, but my mother swears she told him. Pain began to increase and so did my mother’s lethargy. Her activity level decreased rapidly concerning both me and my brother. Another doctor’s appointment was demanded, the doctor scheduled a CAT scan. Computerized Tomography (CT scan) is a procedure that assists in diagnosing tumors, fractures, bony structures, and infections in the organs and tissues of the body.
The day of the CAT scan mom came into my room and asked me to take her. This is a BAD sign, my mother is VERY independent. I got up put on dress pants and the professional’s armor to play the ‘game’. I was no longer going to allow the ‘system’ to blow my mother off.
The day’s schedule was scan at 9am then acupuncture at 11:30 am. Scan results would be required, in my mind, before leaving town, living 50 miles from any hospital I wanted results and answers before trekking back home. Mom’s condition worsened that morning with a raging fever. The acupuncture appointment was cancelled and we went to back to the surgeon’s office without an appointment, this is where it got interesting.
The ‘game’ that is played in the medical ‘system’ can be manipulated. I have manipulated it in many ways, many times. Friends who have seen me apply manipulation to the ‘system’ no longer go to the ER without me, I know the questions to ask and how to circumvent delays. The doctor’s office probably looked like it did any other day at 11 a.m. I immediately requested the surgeon’s nurse whom my mother had been referred to by her general practioner from the very beginning to handle the ‘pulled’ muscle. She was a sweet dark haired woman who I purposely manipulated. I told her I believed that my mother was becoming septic, and I did believe that, her eyes widened. We immediately got a room at the Inn. I did not use this word lightly, my mother was on the cusp of sepsis, in my opinion. The fevers were occurring with increased frequency and voracity, and she was currently burning up, as my grandma would say.
The surgeon made a rapid appearance. He immediately lectured me on the definition of sepsis while leaning on the far counter of the private patient assessment room as his 3rd year med student stood in the corner by the door. They were obviously irritated by my manipulation of their ‘system’. The surgeon did not have a stethoscope or even bother to touch or assess my mother before he declared that she was sick because she had not had the flu shot and probably was developing pneumonia. I sit quietly not responding until he asks why she has not had the flu shot, to which I reply that the efficacy is less than 30%. We are obviously not going to become friends at this point of the ‘game’.
I am angry, quietly angry I may add, in the not to distant past I would have been unable to sit and take this quietly. I politely ask the med student if I can borrow his stethoscope. My mother’s lungs are clear bilaterally, which means she does not have pneumonia. The surgeon goes on to state that he takes his family to the urgent care center on the first floor of the same building and that we should go there. He then states that the flu shot is universally accepted and that sometimes you can’t understand all the facets of medicine and that one must have ‘blind faith’. Now at this stage of the ‘game’ it is amazing that I have not turned into some alien that has a head that can spin 360 degrees with huge amounts of steam coming from every imaginable orifice. I have now met the most ignorant doctor I know, and I know quite a few doctors and call many friend. I am normally a fan of arrogant surgeons, they know their trade and it requires a bit of arrogance to do what they do. I am not however a fan of incompetent arrogance.
I leave the surgeons office with my mom and head to the urgent care where we are cared for by al lovely white haired doctor that reminisces about being able to smell the flu until recently. This doctor speaks my language because I can smell the pre-sepsis on my mom, it is something you can’t describe but something you learn to identify after caring for 1,000’s of patients a year. This doctor agreed with me about my mother’s lungs being clear and pneumonia free, and he actually had a stethoscope, touched and assessed my mother. He listened to the entire medical history and ordered a flu test and a full blood workup upon my request. We spent 1.5 hours in the tiny room with the tiny half bed that my mom actually fell asleep on, something she would never do unless incredible ill. Did I mention that I was also reading “Over-diagnosed making people sick in the pursuit of health” by Dr Gilbert Welch for the second time very purposefully, it is all part of the ‘game’.
Hearing has always been one of my strong suits and as we wait I hear the urgent care nurses go into a flurry. The surgeon from the 3rd floor is going to grace urgent care with his presence. I woke up my mother by saying ‘The surgeon from on high was wrong and I was right and now he has to come grovel in urgent care.’ I also channel my father and state that he and I are going to have to make a visit to the ER to remove my foot from his rectum. I am beyond angry now. He entered the room with his med student in tow, and the poor student again seemed to be prepared to rapidly exit the room, the first time was because the surgeon had probably ranted about an inappropriate patient family diagnosis, but this time it is because his teacher was about to get his arrogance handed to him. Did I mention that I am 5’8” in heels and he is 5’5ish? I stood up and approached him. He immediately apologizes as I looked down on him in more than one way. The CAT scan found an abscess while her white blood cell count was also through the roof. He was going to immediately admit to a sudo ICU and place a drain for the abscess.
I told him that during his tirade upstairs he had gotten himself fired and I gave him the advice of NEVER again telling another patient that he has ‘blind faith’ in medicine as it smacks of IGNORANCE, I thought the med student was going to pass out. If this had been done to a cute old couple they would have gone home and a fatality may have occurred, progressed sepsis is very dangerous (and the news is currently covering that with young boy who just died). They would have thought it was their own fault for not getting a flu shot, this type of over sighted medicine makes me absolutely and irrevocably CRAZY.
Abscess can occur close to the colostomies as the human body is not as different from the rest of the world as one like to think. The analogy I use with my family is welding. When you weld two things together the weakest point is right next to the weld. The scar tissue in the body is like a weld and the skin next to it is the weak link, to add insult to injury there may have also been a diverticuli that added to weakened area that began to actively leak at the end of September, although the ‘new’ surgeon now believes it had been going on for much longer as there was crystallized septic tissue that she removed. It is now the week before Thanksgiving. We now know though that the problem started before the end of September as a very slow leak but the dam broke when she thought she pulled a muscle.
There is much more to this story, that I will place in the next blog, mom is now healing and the ‘system’ has been circumvented once more.
The moral to this story, NEVER trust a doctor that has ‘blind faith’ in any part of medicine and especially if he is ignorant enough to admit it.