Wednesday, June 20, 2012

The Golden Rule

The archaically stated “Golden Rule” (Do Unto Others…), has morphed into the passive voice as the truism, “others treat you how you treat them”.  I realized myself that whichever way I perceive it, either with myself as the subject and actor in the active voice; or, as the object of another’s action in the passive, I found myself treating others with the prejudices of past experiences in similar situations. 

Ruminating on what led me to act this way, and how to change my (often embarrassing) negative behavior, I rationalize through frustration.  The group that is the aim of my prejudice are those who are in positions of service.  In this case, specifically the medical assistants and staff at the Houston area physicians offices. 

I have, unfortunately, had many problems with the staff at my primary care physician.  Being on a MediCare Advantage program is like an HMO. I must see certain doctors. Pre-authorization is practically required to take my blood pressure! Ok, exaggeration, but for just about anything. The doctor does no physical exam under any conditions. No stethescope, no little flashlight, just a laptop.  I get 7 minutes (which I think is timed on the laptop!), as he struggles through the commands.

Me: “I feel sick.  I can’t breathe…wheeze, cough, wheeze, gasp, wheeze”

Doc: (Scoots back 3 feet, stares at keyboard) Here’s two prescriptions.

After a while this gets…upsetting. Especially since it takes an Act of Congress to get a message or a refill request to the doctor.  Yesterday, I asked for an appointment and a message to the doctor, and the receptionist said in a snotty ghetto tone “You can’t have everything you want, one or the other, not both”.  I could not help the word “bitch” from coming out of my mouth.

But this is not the case with every doctor’s office in the area, and I have had to make more than one apology by beginning conversations on the defensive.  It has become how I talk to the staff at Synergy Medical Group, how they have treated me.  Even still, reacting to their antagonism is not productive either. 

I have many problems with the lack of medically trained staff in doctors office.  There used to be a time when actual degreed nurses worked in doctors offices.  Now their training mostly consists of memorizing terminology and a multiple choice test.

Realizing this, and taking responsibility for my own disappointments, I plan to go forward with a better attitude towards the staff I have to deal with.

 

Count down to surgery, one week!

 

Winking smile

Kimmarie

Monday, June 11, 2012

Goldfish and Soy Sauce


Monday, June 11
Wow, I can ramble on with some crap, huh?  My apologies. 
I finally got some sleep this weekend, and spent some time on Oxygen.  I woke up late this morning, feeling very good.  Insomnia is one of the more difficult symptoms to deal with, and the raging moods and insignificant minutia.  Sill, I track my loud complaints and sleepless nights, to journal this experience.
Sometimes I need to plant some seeds, but it’s not the kind of thing one can plan.  Going to look for someone who is in need for that purpose isn’t genuine, it doesn’t work that way.  It is more of a “what would you do?” type phenomenon; someone must trust me enough to ask me for help.  Then, do I have the character, the strength, the love to be there for them, as well as the insight and honesty to know if I am capable of helping them. 
From a place I would never have expected, I was asked and was able to be there.  I believe that I attracted the request because I was honestly open for it. I also believe that I received more than I gave. 
In other news, I went fishing yesterday, but didn’t catch anything.
Two weeks ago, Donna brought me an Aquarium!  We set it up, and let the water set for two entire weeks.  She brought a plant over, and made a great home for my future new pet.  Yesterday, she came to take me to get a fish for it.
I was disorganized, and it took me forever to get ready.  I was also clumsy and knocked a bottle of soy sauce on the floor.  What a mess!  Of course, Donna rushed to help me clean it up…hell, she did clean it up.  Her little 5 y/o girl was mopping, too cute.  One comedy of errs after another and we went out and ended up back at my place sans fish.  Thank you Donna, for having the patience of Job with me!  We will get a fish soon, I’m sure, and I will post a picture of it. 
More later!
Winking smile

Saturday, June 9, 2012

Do Not Resuscitate

 

Friday, June 8, 2012

Yesterday, though the thermometer only said 88, with humidity at 80%, the air felt well into the hundreds, verified by the Weather Man. I had to drive to the Surgeon’s office to sign the consents for surgery.

I did try to get a ride, but everyone happened to be busy on Thursday after noon. The office called at about 2:00, I was preparing to leave but had an episode of tachycardia, and had to wait until I could see again to drive. When my head stopped spinning, I walked the 500 feet to my car. When I opened the door, I could feel the heat pour out, but the doctors office was anxious and I was late. Of course, I had to regain consciousness again. It took a few minutes to get feeling back in my legs. And I went.

After a harrowing drive and getting lost, my daughter Allie called just as I arrived to the office.

“I can’t get a flight until the 27th, do you want me to come at 9:00 or at 12:00? Matt can come pick me up.”

“Allie, I’ll be in surgery at 9:00am! It’s creepy to think if something happened, no one would be here!”

When I found out that the surgery was scheduled for the 27th, I had told Allie to just make the plans to get here as soon as she can, that I cannot make these decisions.

“Let me go see what they say, and I’ll call you later,” because I really thought that this was the appointment that they would explain everything to me about the surgery, give me my test results from the last two months, and answer some questions.

None of that happened.

I had a difficult time initialing the statements that said things like “I have been given other treatment options”, and “The procedure has been explained to me.” I told her, I can’t sign this. NONE OF THIS HAS BEEN EXPLAINED TO ME. The doctor diagnosed me, sent me for releases from pulmonologists and cardiologists, had two months of tests, and then would perform the surgery on me without even talking to me first! I was appalled, and frightened, but not surprised. I have received medical care in four different states, but the physicians and allied health workers in Houston are the absolute worst. I think even Louisiana has better health care! You certainly wouldn’t know it from the media. Unless you are rich, famous, or otherwise noteworthy, Texas has the worst health care in the U.S., and the most uninsured, who receive NO care. Where else would Michael Jackson find a doctor that would set up general anesthesia at home? But I digress, and this is for another argument, possibly another day.

So the office girl (not a nurse, in Houston, I’ve only seen poorly trained med techs, surgery techs, but never an RN) made an appointment for me to see the doctor to answer my questions. Why wasn’t this done all at once? Gee, thanks for making me risk my life once more to get here again.

Having an appointment with the surgeon, I went ahead and signed the consents. They can always be rescinded.

On the way home, I stopped to pick up a prescription. When I got out of the car, I noticed that some one had busted out my tail light. I’m certain it happened in this fine hood I live in. I called the complex security (who are off-duty HPD), and a “note” will be made. Now that’s what I call some fine police work. The perfect ending to a horrible day. Now I have to figure out how to get this fixed, and pray that I won’t run out of water and that my three Ensures keep me conscious until I can get the tail light fixed because the cops WILL pull me over for that, needlessly search my car, and make up something to give me a ticket. I called my son, but he will only be able to spend a few hours here before my surgery, and will not come again until the night before my 5 am check-in.

That night, I checked flights from Phoenix to Houston, because I just couldn’t believe that all the flights were booked three weeks before! Of course, they weren’t, and I realized that Allie would not be here simply because she doesn’t want to be. When I asked her why she couldn’t come earlier, she informed me that she’s going to Flagstaff the day before. WHAT? When she called me “unappreciative”, I had to say goodbye for now and hung up. Then I threw up. How it hurts that to her I mean so little.

So it’s easy to see how I hung in a delicate balance between depression and anesthesia today. While I’d like to say that I was simply calm, the truth is that Xanax® was probably more responsible for my emotional emptiness than natural tranquility. Call it a condition of my illnesses or of a cancer diagnosis and pending surgery, as hard as I try to stay positive, some days are more difficult than others. Today was one of those lost days.

It is also the condition of my life that I have the energy of a coma patient after any activity, such as grocery shopping, cleaning, going to the doctor, doing the laundry, and the many other things needed to be done and places to go in a city of six million. “Friends and acquaintances” often say ‘Please call me if you need a ride or anything!” And I’m thankful for the rare times I am relieved of the life-risking task of driving. Still, the alternative has its own limitations and stresses. People are busy and in a hurry. My pace is slow. I’d speed it up if I could, really. The hardest part is getting food. I quit asking people to help me get to the store. After being told, “sure, how’s next week?” so many times, I give a grateful thank you but don’t feel the need to explain that the human body needs food and water daily (Houston tap water is not recommended for drinking). I assume it is something that everyone knows, but I doubt few of my friends have ever experienced hunger due to the inability to procure food for days at a time. They do not understand what I mean when I say I need food. In America, we think that hunger is a childhood condition of poverty. For example, although I qualify for food stamps because my medical expenses bring my qualifying income down to an impoverished $300.00 a month, Texas awards my $16.00 a month in Food Stamps. If a child were involved, the amount would be nearly $300.00 a month. This begs the question, are the disabled and elderly seen as having any value in our society? Certainly, they do not in Texas.

Having a very limited diet of soft or liquid nutrition that will pass the tumor in my throat already makes eating a challenge. I hold off as long as I can, because eating is painful and I’ve never been much about food anyhow; but when I start fainting from lack of nutrition, I have no choice but to risk it and make the trip myself, even weaker than when I first asked for help. Though I’ve had a quite a few close calls driving to the store, I’ve only lost consciousness once while shopping. Since then, I just pick up a few things. I carry as many of the refrigerated items as I can in (it’s about 500 feet from my car to my door, I can make one trip, carrying five pounds total. Anything else has to stay in the car until I can get someone to get it out…it could be hours, it could be days.

These may all sound like silly problems, and one can’t imagine that I really am in this situation, but it is these things that make me want to reconsider the surgery. I don’t have any idea how on earth I will be able to complete all the tasks I have to do before the surgery. I won’t bore you with the details, but if it does not absolutely need to be done, it is not on the list.  Many of these things only matter if I survive the surgery, though.  With my horrible luck, I probably will.

Other thoughts that go through my head include doing everything I can to MAKE SURE I do not wake up from surgery. Perhaps a Carton of Cigarettes and a few bottles of Aspirin or Ibuprofen the few weeks and for sure the night before the surgery? Do every thing on the list that I’m not supposed to, and don’t do any of the things I am? Lose the weight I’ve gained, and pray pray pray I don’t wake up?

I have my Advanced Directives written out, including a DNR, and a special note regarding surgical risks, such as severing my vocal cords, and after that having to live with a tracheotomy. No thanks. So I will make sure that if anything goes wrong during the surgery, they won’t rig me back together as a vegetable, and consider that life.

Perhaps things will turn around for me, I want to believe that my mood will be positive. But there is a very big part of me that DOES NOT WANT TO WAKE UP.  First, I need to find out my options, and how long and how bad things would be if I let it go.  It’s already been nearly 8 years since a Louisiana doctor first diagnosed the tumor, and I have been begging for treatment for the last five, so perhaps enough time has passed for metastasis.  That would be the best outcome, for certain.

It’s nearly 5:00 a.m., and I’ve yet to sleep.  My mind is racing and if I stop it, I’ll only fall into a sobbing heap of hopelessness.

Lord,

kill me or cure me, what ever your wish, but please relieve me from this purgatory.   

Amen. 

kmarie c 2012

Tuesday, June 5, 2012

Something To Be Thankful For…

 

There were several times this week when I scribbled notes for a blog entry, and even sat down to write a days post but was distracted by Facebook messages and e-mails. 

When I find myself bummed out about something, and pep-talk myself back to realizing the beauty of my life, I often quickly forget and return to the old habits of thinking that led me to depression in the first place. 

The last message I wrote myself, No More Boring Weekends, was more than empty words on a page that sounded pretty.  It really is working, and I continue to find evidence of it’s efficacy.

I’m not even saying that I simply had a good week, because in many ways, it was difficult.  My pain level was up, I was very tired, and there were two days that I barely even got out of bed.  Threw on some shorts and a tank, pulled my hair back, and then laid back down on the sofa and slept to the TV.   That was after a mean Cardiac Profusion (Chemical Stress) Test.  The tech couldn’t get the IV in, and after 6 painful digs, asked “let me see your feet”

“Forget it!” I protested.  “Do I even need this test?…I want to talk to the doctor!”

The frustrated tech sat me in the hallway, Dr. Chang taking only a minute to address the issue.

“It must be done!”  he said in broken English. “This test will tell if you have blockage, and if you have heart attack during surgery. You can not have surgery without!”

“You be fine”, he went on, “It won’t hurt”

Famous last words.

The test is done in three parts: After placing an IV, a special x-ray is taken of the chest (heart); next, the tech injects the medication that “stresses” the heart and an EKG is performed; finally, radioactive tracers are injected and another x-ray is taken.  Between each, the patients were sent back to waiting room.

“Well then, don’t even make me walk back and forth to the waiting room!” I snapped back. 

“You got one chance” I told the tech sharply.  A good phlebotomist would have placed the IV correctly the first time, I was thinking to myself, so I had little faith in the techs technical abilities.  He stuck my foot and missed.  My eyes were closed tight, I took a big breath as he dug around and I squirmed.

“Hold it! I got it….don’t move” 

It hurt like hell, and I let him know it, along with a “You LIED!”

In the end, the test was completed, and I left with a big blue bruise on my foot.  I’ve jumped through every hoop the surgeon has thrown me.  This test put me down for a day or two, but in the end, I was thankful that I most likely will not have a heart attack while on the operating table. 

Now that’s something to be thankful for!

kimmarie Winking smile