Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Wednesday, August 19, 2009

Hypertension: A Rant

rights purchased from iStockphoto.comHypertension is a disease for which there is no cure. If you have it be advised that you have expected too much, borrowed too much trouble from the future, and overstayed your welcome. It is an extremely slow death from which there is no escape. Everyone gets punished somehow. Hypertension is one how. Conversely, it could also be construed as a favor from the universe allowing you to slowly fall asleep, to painlessly and gradually fail until sudden death takes you. A heart attack can be painful and no one wants renal failure.

Renal failure is one of those bright red flashing lights that paralyzes any common sense your doctor may have. Even the thought of a whisper of those words strikes her dumb and useless. The pen comes out. There is a blink of the eyes. The face stops working as if in hyperdrive stasis and then suddenly reactivates in an alternative future dimension. The pen moves. Scripts get written. The doctor breathes. All is right with the world again.

I on the other hand stop breathing because I know the doctor hasn't a clue what is wrong with me or how to fix it and is disinclined to broach the topic. She is also firm in her belief that consulting with another doctor is a sin greater than moronity since this is hypertension — a basic problem of life. I sigh and take the script. Here we go again.

There are a lot of superstitions about hypertension, just like cancer. And, just like cancer, the "cures" are magical and defy explanation: deep measured breathing, losing weight, exercising, following the DASH diet, organic herbs, tinctures, group support.

I think it has to do with being a herd animal in flight mode. When attacked by a perceived predator, a herd of wild animals panics and races to the horizon seized by communal fear. The animals drop logic in favor of brute force, forcing themselves to run.

As they run, members of the community are picked off, falling in the center or along the group perimeter. The fear factor increases and the herd tries, if possible, to run faster shedding any remaining logic in order to focus fully on the goal of losing their attacker. Those closest to the lost ones exhibit disorientation. They stumble more, their eyes move wildly back and forth, they rely on the press of bodies to carry them in the right direction. Subconsciously they calculate their chances of survival and whether or not the statistical finger of fate will select them or their neighbor. Their fear separates them from the herd, makes them an individual. The herd can't help them now. Their attacker is more powerful than the herd.

The survivors sense that death is inevitable and yet keep running anyway. Hypertension is like that. The unknown enemy that keeps you running. The unseen lethal opponent lurking just out of sight with a magic mystical touch that can reach into any part of the herd and select a victim at will. Those who survive are rewarded with adrenaline enhanced maniacal running — grabbing at whatever solution they can get.

Why is there no cure for hypertension? Because it concerns hormones, about which we know little and which are mysterious and complex. Because it concerns the liver about which we really only know that it is essential and that damage is generally irreparable. This is the fear in the doctor's eyes. The common cold no one can cure. A lethal common cold that will kill you no matter what.

The only treatment is prolonging the agony. Slowing down the predator and maybe helping the victim to run faster or to not focus on those dropping next to them. However, in the end, hypertension will get you. It's just a matter of time.

Monday, August 17, 2009

What's wrong with socialized medicine?

Socialized medicine is not socialism. Socializing medicine seems to be the magic bullet that will fix all our health care ills. The reality is far from the dream. According to my experience, anyway. I've twice been the victim of socialized medicine. Okay. Victim is too strong a word. Let's leave that for now.

My first experience with socialized medicine was in England where I gave birth to my second child. You can't go by pregnancy and birth because they can't wait. Not like gall stones, hairlips or bone spurs which can be put off for a very long time indeed. As a pregnant person I received priority treatment. My then mother-in-law with gall stones ended up on an 18 month waiting list and was only bumped to the head of the line after 7 months because the only thing she had been able to keep down for weeks was warm water.

Some people think that socialized medicine is good because the poor will have the health care they need. In my English situation I lived in what we in America consider to be an upper middle class neighborhood. So did my mother-in-law. We weren't poor or needy by any stretch. What happens is that patients flood the system without a comparable increase in doctors. The doctors and hospitals get overloaded.

Those with discretionary income who can pay for private care can jump to the head of the line. And we're back to where we started. The poor and those who can't afford the premium prices of private doctors, including professional couples with children, are put on hold for just about everything but emergencies. They are seen by overworked doctors and end up in thinly staffed hospitals.

This is much like my experience now. I am unemployed and have qualified for free local health insurance offered by Virginia Commonwealth University's Medical College of Virginia. The program is also know as VCC (or Virginia Coordinated Care). My coverage is much like an HMO. I have a primary care physician and can't see a specialist without a referral. For emergencies I can only go to the Medical College of Virginia hospital (MCV).

The emergencies work out fine. Socialized medicine is set up for emergencies and other priority conditions. Of course, I still sit for hours with all kinds of people, although MCV has a special streamlined system (two hours instead of four) for those who are "in-and-out" patients.

On the other hand, it took six months for me to get to a Urologist and two months to get my first doctor's appointment. Originally the Urologist had scheduled my appointment for a year out, but my doctor and the patient advocate managed to pull some strings to get my wait time shortened. Getting a taste of this? Good.

As well as quantity, quality also suffers. Since doctors are in such demand you get all kinds of doctors. Urologists who cause off-the-charts pain with a q-tip. Doctors who can't get your blood pressure medication right or who refrain from referring you to a specialist for any number of reasons — one of which may be that the system requires they exhaust certain options before referring. Another may be that they are just too overworked to keep up with any patient who isn't teetering on the brink of emergency.

It would be great to provide some kind of health care either permanently or temporarily for those who can't afford to pay. I don't know what that looks like. It doesn't look like anything I've seen or heard about so far. Whatever system is created, the patient should bear some financial responsibility, no matter how small. And there needs to be enough doctors and hospitals to go around.

How will that be paid for? I don't have an answer. Right now the American system is being stretched to the limit with record unemployment and the boomer retirement bombshell. Can we afford socialized medicine? Can we afford to not have socialized medicine, keeping in mind that prevention is a lot cheaper than treatment?

I hope a workable a solution can be found. I hope everyone who is able and willing helps find a solution in a peaceful, fact-finding, respectful way. Best of luck to those working on this problem.
Current Fads
Listening. Somebody Like You, Silver Screen Soundtrack Orchestra; susurration of Air Conditioner
Watching. The Fifth Element (1997)
Activity. learning how to navigate free health care; dealing with 10 months of unemployment
Gadget. resuscitated Palm Zire 31
News Source. the news feeds in Safari
Reading. Fruits of the Poisonous Tree - Archer Mayor; First Impressions: What You Don't Know About How Others See You - Ann Demarais and Valerie White; facebook and twitter updates; Garage Band help
Writing. this blog post; morning pages