| A Long Day with the VA |
[May. 22nd, 2008|09:11 am] |
It is apparent that the communication between various elements in the VA system is particularly awful. It is equally apparent that it's because they are processing so very many people at once, every day.
There are a lot of military veterans.
More to the point, there are a lot of military veterans who do not have access to any other insurance or health care that is worth a shit. There would be no other reason for them to endure the unmitigated horse feces that is the VA system.
(And, yes, my more conservatively-minded friends, if this is the model that a more universal health care system would be based on, I would be horrified. But I would still take it over the alternative... which is to say the nothing that we have now. At least my father can have this life-saving procedure without ruining the life of his wife and family afterwords. My contention, however, is that there can and should be a better way - not just for the vets, but for us all. The VA model should be an example of how not to set up comprehensive health care for U.S. citizens; it should not stand as an example that we should just give up on the idea.)
The local VA clinic physician cares about my father, which I truly appreciate. She did her best, of that I have no doubt. Unfortunately, she is not particularly well-trained on dealing with AAAs. She thought it was much worse that it actually was; yes, this is a "good" thing, but it still created trauma and miscommunication for all concerned. As well, she clearly knows very little about the actual hospital she deals with, and the two elements have very poor communication about the logistics of the care of their patients.
For example - my father was told he was to report to the Vascular Surgery Clinic in Pod C between 9-10 AM yesterday morning; it was urgent he be there by that time, in that place, so that they could quickly assess him. He was likely to be admitted for tests, observation, and eventual surgery. We planned accordingly; packed for the extended stay, and I put the word out for a cheap place to stay. Mom drained her bank account to help fund the trip with what little she had.
Only the Vascular Surgery Clinic isn't in Pod C; it's clear across the building. And the appointment wasn't for 9-10 AM; it was specifically for 11:20 AM. And, thanks to some apparently clerical errors (overheard from a stressed-out admittance tech), the place was almost triple-booked that day.
So we waited in the cramped, ugly little space, having nothing to eat and afraid for Dad to go to the bathroom in fear of missing the all-important call-in, until nearly 2:00 PM (Central; we'd left before sunrise EST).
And we waited all that time to discover that (a) the aneurysm isn't quite as bad as his physician thought (due to poor training on how to read aneurysms in the imaging used); (b) it's still bad enough that it could pop and kill him at any time, so it does need to be dealt with; (c) nothing was really going to happen that day, other that some more tests in another department; (d) the surgery is at least 5% likely to kill him, while the aneurysm is currently about 8% likely to kill him.
But the risk of the AAA killing him will go up rapidly over time, and the surgery risk can be minimized.
So, we go back next week. We head out sometime on Wednesday, get a cheap room somewhere in Nashville, and maybe grab a decent dinner, Dad and me. First thing Thursday morning, we run the gauntlet of tests and procedures, starting at 7:00 AM and going to late in the afternoon (with lots of waiting between). After that, Dad gets admitted and will stay in the hospital through the weekend, while they get his blood where they want it and test other factors.
Monday, June 2nd, he has a procedure called an "embolization," which apparently lays some kind of important groundwork for the eventual real surgery. Then he comes home and waits until said surgery is scheduled.
Which, apparently, we shouldn't expect to happen for another 2-3 weeks, at least. Assuming they can get all of his factors where they want them.
Because, yes, Dad's horrible health (dramatically impacted by his smoking*) is making this way more risky and difficult that it would otherwise be.
So the crisis continues, and will for some time. That thing could still pop at any moment while we are waiting, and there's no way around it - if it goes, he's gone. No emergency service can stop it. He'd have to be on a surgical table, cut open, within about 10 minutes to even have a chance.
And yet no hospital will admit him long term to watch and monitor. Not the VA, and not any other managed care program. No insurance will cover it. They refuse to waste money like that. Somebody's yacht might not get a new coat of paint. Men in my father's situation are told to go home, do nothing, try not to stress, and pray.
So there it is. Fun stuff.
I would appreciate it if the Universe would stop shitting on me and my family now...
* My Smoking Friends - You are a stubborn, pig-headed, addicted lot. You think this makes it OK, that you are rebels who won't be told what to do. "I love to smoke, and something's gonna kill me anyway. Might as well be this. Lettuce causes cancer, a bus might hit me, blah blah blah..."
Fine. I am just telling you, the one doctor said with no hyperbole and great sadness "We could just about do this today if it weren't for your father's smoking, and it would be no real big deal. Because of what he's done to himself, however, I don't like his chances at all. Never mind that the smoking very likely caused the aneurysm in the first place..."
Yes, other things are bad for us all, too. That does not make smoking a smart or reasonable choice; its impact on your daily health is a constant and very real negative. The science is irrefutable. The facts are there, no matter what your addiction tells you otherwise. I love you. Please quit. I absolutely promise you that you will regret not quitting later. My father does. |
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