It's Friday, January 3, 2014. You just woke up with a wicked bad pain in your left side...

[cherokeeprogressive]

Last edited Sat Oct 5, 2013, 03:13 AM - Edit history (1)

You have a history of diverticulitis. It hurts so bad you didn't sleep all night long. In the morning, you call your doctor, thinking you'll go in and have him give you something for the pain... So you call work at about 6:30 and take a sick day... and try to go back to sleep.

You doze on and off and finally call your doctor's office at about 8:30.

The Receptionist says your Doctor can work you in...

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[Avalux]

1. Is it acute and life-threatening?

If so, then go to the ER immediately. If not, then you may have to wait a few days.

[cherokeeprogressive]

2. Chronic... you have a history. Check the date. It's two days after ACA becomes effective. n/t

[Avalux]

4. Help me out please.

I'm not sure the answer you're expecting. My post is based on my own medical experience.

[grantcart]

5. He is making a subtle point.

After Jan 1 millions of people who have pre existing conditions will be insured and have made appointments in December to see their doctors.

It could jam up the system for weeks, or months.

It will create a significant stimulus for the medical industry because of sudden explosion of pent up demand.

[Avalux]

8. Ahhh. I get it now....thanks.

I posted in another thread about the influx of new patients and seeing how it's managed. And as I said there - would be a great time to get licensed in the medical field.

[regnaD kciN]

11. Actually, a not-so-subtle point…

…considering that there's no option in that poll for "come in right away, we'll fit you in."

It's no different from the "push polls" so beloved of conservative P.A.C.s, where every answer allowed skews toward the point -of-view the pollster wants to promote.

[Pretzel_Warrior]

14. eggzactly

and again. Since we're talking about 15% total of Americans not insured and part of these being healthy people who choose not to be insured, I would say the workload will not be entirely unmanagable.

Besides, once the death panels kick in--problem solved!

[Sheepshank]

62. So are we to assume all previously uninsured persons will get sick jan 4

and they all want to see the same doctor on the same date and jam the system?

I honestly thought there was a different underlying premis going on...although what it is is beyond my grasp today.

[cherokeeprogressive]

15. Exactly. Thank you. Demand will explode though, then dimish.

From everyone with an ingrown toenail to everyone with a chronic cough to everyone with chronic headaches...

I suspect that logjam will mysteriously disappear though around June or July when people find out there is a Maximum Out Of Pocket expense.

Health Insurance isn't the same as Health Care.

I don't understand how it is people don't get that.

I can hear the Insurance companies rubbing their hands together as I write this...

[Fumesucker]

21. That has only been explained here about a googol times

At this juncture anyone who "doesn't get" it is putting their fingers in their ears and screaming "I can't hear you".

[Ms. Toad]

35. Your second comment doesn't make sense

Why would fewer people be using medical services because they learn their medical care does cost them anything at all after they spend the maximum they are required to spend in a year?

[CTyankee]

33. my primary care doc (a liberal Dem) predicted that exactly that would happen...

Not enough pcp docs to handle the load.

My solution is to pay the pcp docs more and make it an attractive field for med students to consider.

[cherokeeprogressive]

41. My solution to the whole problem would have been to flood the system with doctors.

Pay for the schooling of EVERYONE who qualified.

I think in the long run that would have been about ten THOUSAND times cheaper.

[CTyankee]

50. Of course! Right you are!

[Sunlei]

51. USA visa is very accommodating for foreign professionals like Doctors.

We have a lot of Doctors & medical personnel from other countries these days.

Your ideas are good. 'Obamacare' should lead to an economic stimulus for jobs in the medical field, medical schools, jobs for returning Vets and our regular 'pcp Docs'.

[CTyankee]

54. My new surgeon is from Nigeria and he is wonderful! He repaired a ventral hernia I had and

my recovery was quick and I experienced less pain. When I initially explained to him my fear of pain, he took my hand and said "I would treat you as I would treat my own mother." I have to say I got tears in my eyes, he was so comforting and kind.

[REP]

3. Me? I wish it were only diverticulitis and left-sided pain

But as I've had severe right-sided pain and every other symptom of acute appendicitis so many times I've lost count and have gotten a variety of diagnoses, I'm either staying home or going to the ER. An office appointment usually isn't appropriate for acute abdomen.

[cherokeeprogressive]

6. I woke up in the middle of the night doubled up in pain thinking I had appendicitis.

Spent most of the next day in the ER in and out of a whatchamacallit (catscan?) and found out it was diverticulitis.

[REP]

9. Fun way to spend a day ...

Whatever it is that's going on in there with me (chronic subacute appendicitis? regional ileitis? Crohn's? etc) is puzzling enough that when I do think, "okay, this time it's going to blow!" it turns out the ER staff can't tell for sure either. So now I don't worry about it unless I'm having some spectacular new symptom ... and then I'm not in a big hurry to go!

[CTyankee]

34. I had severe diverticulitis in 2006 and it took forever to get into a gastroenterologists office.

When I did, she ordered up a colonoscopy and that is what showed the true cause of the pain. I was on some of the vilest medicine I ever had to take. The colonoscopy was no fun either: I was told I would feel no pain and not remember anything, but I did feel pain and that sure was memorable! I even remember asking for more sedation and being told "We've given you all we can." I should have been put under general anaesthesia, not just sedation. With a severe infection present, no wonder dragging a scope across inflamed tissue caused pain! Geez...

[roamer65]

39. Bad move on her part.

A colorectal surgeon would have started you on antibiotics, got your colon calmed down then went in to take a look when it was not "hot". A CT scan would have told them all they need to know when you were "hot". In honesty, I have very little respect for GI specialists. Most of them are hacks. The ones that know their stuff are the colorectal surgeons.

Thank goodness she did not perforate you during that colonoscopy.

[CTyankee]

49. Oh, and that's not the end of it, either. I had the surgery to make sure I didn't get diverticulitis

again (cholectomy?) and developed scar tissue. My surgeon (general surgeon) went back in to clear the scar tissue. Then an infection ensued. More surgery. took 6 months in all to completely heal. So the next year it was time for the next colonoscopy. Doc hadn't done his homework. He called me and said he saw "something" but didn't know what so I'd have to have another test. I asked him if he had talked to the surgeon about all the previous surgeries since they must have left a mark. He said "I wish I had thought of that." And these docs practice at Yale-New Haven Hospital, fer chrissake...

I have since switched practices...

[CountAllVotes]

60. I had that surgery

Did I recover? No I did not recover.

I got home and found myself attached in to the sofa unable to move.

I called my doctor and advised that I was in the worst pain I could ever remember having.

I was RX'd morphine sulfate and advised to rest.

So, I "rested" for another 6 mos., still in horrible pain. I finally got into see the arrogant surgeon and he found a hernia that he "missed" it seems.

So, I had to have yet another operation after that.

He wanted me to go back for a colonoscopy and I never went fearing he'd perforate my insides that are nothing but huge amounts of adhesions from all of the surgeries I've had.

I don't trust him. If he "missed" the hernia, what else did he and will he miss should I dare trust him again?

[CTyankee]

65. Get another opinion. Explain the circumstances and ask for some direction. then check the doc

out online. And try to get some informed information about the doc and the practice.

[CountAllVotes]

68. I'm on Medicare A & B & D now too

And there is but the one surgeon that takes it where I live and that is it. The wait (w/appt.) is usually 3-4 hrs. in the office just sitting there ... waiting ... waiting ... along with a room filled with other people on Medicare.

If I want to try to find someone else it would require traveling a long distance, something I can no longer do with any amount of confidence or certainty, plus I'd need money for a hotel and transportation if I could find someone else that might not be any better than this POS here.

I'm another one of these Catch-22 people, broke but not quite broke enough.

This whole experience has ruined my already poor health and frankly, I give up and have signed papers stating such that sate NO MORE OPERATIONS.

I frankly hope I just pass away in my sleep at this point. That is my wish.

[CTyankee]

69. Oh, I am so sorry to hear of your situation!

It is terrible what happened to you. I hope you find some peace. Please take care...

[CountAllVotes]

70. This all began in 2003

At that time I was on Medicare as well.

I had emergency abdominal surgery at that time as well and the surgeon messed up badly I was told (this surgeon is no longer in this state and was fired from her job from the practice she was at).

Oh what a difference a move makes for doctors like this. They flee the scene of their crimes and go on their merry little way leaving behind the likes of me and who knows how many others?

Thank you for you kind wishes. Let's hope that maybe I will get better, it is a possibility. I try to "keep hope alive" but it sure is difficult these days!

[CTyankee]

72. well, I still wonder if my surgeon (now retired) who was considered tops in his field, could have

screwed up and just covered it up to preserve his reputation. But I never heard of anyone else hurt by him so I just have to suck it up.

Not that my situation is bad. It isn't. You certainly had to suffer much more. I wish I could make it better for you. You don't deserve this...

[roamer65]

42. If they prescribe you antibiotics again...be very, very careful around...

the fluoroquinolone class of antibiotics. The quinolones can have rather nasty side effects after repeated doses of them, even if the doses are staggered. They go by the names of Ciprofloxacin, Levaquin, Avalox, etc, etc...

I say this from experience. Ask for alternative antibiotics to them, IMO.

I say this to everyone, in fact.

[WinkyDink]

55. I once was prescribed Cipro..... I read the small print and decided NO WAY.

[winter is coming]

56. I had that a lot my senior year of high school.

A couple of years later, I was tested for allergies and handed a list of foods to avoid. Turns out that I can usually eat one thing I'm allergic to (if my inhalant allergies aren't too awful), but eating two or more makes me ill -- sometimes queasy, sometimes intense stomach pain, depending on the combination. One of those "intense stomach pain" combos was my favorite lunch my senior year of high school.

[Duer 157099]

7. Other: come in this afternoon

at least I assume that's how it would go.

[politicat]

10. My doctor's office has always built emergent/overlap appointments into their days.

Especially on Mondays. I may not see my physician, but I'll probably see the PA I normally see. They're also very good with discipline and keeping to today's complaint.

I don't think this will change.

[Pretzel_Warrior]

12. a health professional on the phone may deem it wise for you to visit ER

just because you have a history of "x" doesn't mean this morning's acute pain is due to "x".

Depending on the doctor, they may inform you they have a cancellation this afternoon and you can come in then. Or they may be really popular and tell you the next appointment is in 2 weeks, but you can call to see if there are cancellations.

The important thing to remember is...THAT IS THE CASE TODAY! PRE-Obamacare influx of patients. And....a 10% or 15% increase in patient load isn't going to blow away ability of doctors and hospitals to respond.

What will be interesting to see is how much ER traffic narrows down to actual emergencies once Obamacare kicks in.

[onyourleft]

32. Unless more...

...off-hour clinics spring up, emergency rooms will still be in demand. Lack of transportation to a doctor's office during prime time will still be a factor in using an emergency room.

[pinboy3niner]

13. The VA would say come in right away

They'd also say that if it's an emergency don't waste time calling us--call 911 now.

[cherokeeprogressive]

19. The VA put my Uncle Don (My Mom's Brother) off until he couldn't get out of bed.

He was my Childhood Hero. He died in the VA hospital in Loma Linda on the 29th of December this last year.

When I went to see him on Christmas Day, I knew it was the last time I'd see him. He was my childhood hero. Some of my favorite memories were of helping my Grandma make Care Packages with cigs, bubble gum, homemade cookies, polaroid pictures, and cans of Coors all packed in popcorn. I didn't know what the fuck. Some of my worst memories are of being at my Grandparents house and seeing how the mood changed when the phone rang or someone knocked at the door.

My Uncle Don lived under an overpass in Orange County for almost a year... no one knew where he was. The "bad times" didn't really start until he'd been home for years... he was married and had two daughters. He bailed on them, disappeared.

In the end though, he and my Aunt reconciled, my cousins accepted him with OPEN ARMS... but just when it seemed like he'd live the life he'd earned?

Fuck.

[pinboy3niner]

24. I'm sorry about your Uncle Don

The few times I've called the VA's "Advice Nurse" about a problem, I was told to come in now. No appointment, they just alerted the clinic to expect me.

Your reference to "packed in popcorn" brings back memories. That's how people were advised to mail packages for the troops back then, and that's how I got my packages in VN. I have one powerful memory of a good friend getting his Christmas package, packed in popcorn, on Christmas day and sharing his bounty with the rest of us--a month before he was KIA.

I'm sorry about your loss. R.I.P. to your Uncle Don.

[cherokeeprogressive]

28. There was no such thing as "styrofoam peanuts" back then...

Chocolate chip cookies... freshly baked. Remember sandwich baggies? Not the Ziploc kind, but the kind with the pocket and flap. Those were for cookies.

My Grandma hated the cigs, but she put them in anyway. She told me once she hoped He'd give them to His Friends.

Not "bubble gum", but Wrigley's. Packs and packs.

Audio tapes. Reel to reel. Some recorded (all I could think to say was I LOVE YOU UNCLE DONNY!) and some blank. I never got to hear the ones that came back. I think my Uncle Sonny (his Brother) has them.

Steno pads. Envelopes. Stamps.

And... cans of Coors.

Know what? When I was at sea on the USS America, and I got a box from home and it had My Grandma's name on it I could count on it having the exact same things and being packed the exact same way. Once, I got a box while I was on-shift. It was late at night, after flight ops had ended... as I waded through the cigs, gum, cookies, and whatnot, I came to two 16oz cans of Coors. It was like 4 in the morning. You should have seen the wide eyes when I pulled them out of the box... My Sup told me I had to share. We had been at sea for about 70 days. So I popped the top on the first can (luke warm mind you) and downed it post haste and rolled the other one into the middle of the floor. I remember waking up in the corner and getting the next day off.

[pinboy3niner]

31. Warm beer was like manna from heaven

My friend's package, delivered by chopper out in the jungle in a place his men dubbed 'Christmas Hill,' contained chocolate chip cookies, a laugh box, and a fifth of whiskey.

We were supposed to get beer rations from the Army, but we rarely saw them. The supply sergeant and his buddies in the rear helped themselves, even though a beer at the club must have cost only about a dime (I remember a scotch at the officers' club costng a quarter).

On the rare occasions when they did drop off beer to us, it was warm--and heavenly. Its rarity made it even more special--even for the guys who didn't even like beer.

One time, they sent us ice cream as a reward after our bn. fought an all-night battle against an NVA regiment at the DMZ. In Vietnam's heat the stuff was melted before the choppers got halfway to us. And I'd had my platoon stash our rucks to move during the night, so we had to eat this warm, sweet, melted stuff out of our steel pots after we'd had nothing to eat for 36 hours.

From home, my mom mainly sent me chocolate chip cookies and Swiss Miss hot chocolate packages. The Swiss Miss was my 21st birthday toast on a bad night on a cold hill where we got socked in by fog and couldn't be extracted. That was special, even though it was made with water from bomb craters everybody had been urinating in, with charred splinters from the trees floating in it. We just boiled the water a little longer and strained the splinters with our teeth.

The warm beer, though, was a hallmark of service. To this day, I can still drink a warm beer without complaint.

[cherokeeprogressive]

40. You, Sir, need to write a book.

I asked my Uncle Don once when we were drinking together (before he disappeared for almost fifteen years) if he ever actually saw any NVA. What he told me made the hair on the back of my neck stand up. Men like you and him need to document your experiences if for no other reason than to serve as cautionary tales. His memories are gone forever. For yours to disappear as well would be an avoidable shame.

You have a way with words.

God Bless You Sir.

[pnwmom]

16. Are you concerned that the new patients might overload the system?

I''m sure you don't think it's fair to deny care to millions because it might delay your appointments.

[Pretzel_Warrior]

20. maybe good sound medicine like this will come into play

http://www.medicalnewstoday.com/articles/246005.php

Like doctors not working on a fee for service model and diagnosing some interesting sounding psuedo disease so the insured hypochondriacs they treat feel valued and can be BILLED.

[cherokeeprogressive]

25. You mean like my Mom?

I'd stop a bullet for her. There isn't anything I wouldn't do for her.

I NEVER ask her how she feels though... because she'll TELL me, and I don't think I could afford the phone bill.

Thank GOD she's the only person like her huh?

And thank FUCKING GOD there are no dishonest doctors who'd game the system...

[Manifestor_of_Light]

17. This won't apply in Texas to six million uninsured.

Because of our suckwad governor Perry. I'm one of those uninsured.



At least that's what Chris Hayes said tonight. As much as the entire population of Massachusetts.

[pnwmom]

23. People there should be demanding to know why Perry

wants them to pay federal taxes to cover expanded Medicaid in other states but not in their own.

[Starry Messenger]

18. I have no idea, since I haven't had health coverage since 2002

I just plow through feeling shitty and then go to work. I've worked through being in a car accident, really bad bronchitis, near vomiting everyday flu symptoms, and a groin pull. Doctor Google says the pain I'm feeling now and for the last year might be bursitis. I also don't get sick days, since I'm an adjunct, so who the fuck knows.

Anything different than that will be an improvement at this point. I just signed up for the healthcare exchange in CA. Marrying my husband screwed me out of a potential $2900 in subsidies since he makes more than me, but his work insurance would have charged us $900 a month to cover me. We got married to try to get me coverage that way, and then found out the payments would be insane.

I'll be paying $411 a month, with a $1000 stipend from the community college I work for paying back reimbursement every year.

I want single payer, but I don't want to find out I have something worse than I have now and be subject to catastrophic bills.

My monthly bill before getting married would have been much less, so I suggest that young engaged folks do the math if there is considerable income difference between the two of you.

[Egnever]

22. Where is the option for that day?

[Humanist_Activist]

26. Given its not life threatening, the doctor would say in a couple of days to a week, depending on how

busy they are, never met a doctor that was able to squeeze anyone in within a day, if its that bad, they will tell you to go to the hospital.

[CountAllVotes]

58. Diverticulitis is life threatening

I damn near died from this in 2009.

Three surgeries later (after I "abscessed out" having it spread to my appendix and having peritonitis set in), I am still alive by the skin of my teeth.

I never knew what diverticulitis was/is but I sure know now and as for these "surgeons" out there, it seems that about 50%+ of them have not a clue as to what they are doing.

I was going from one doctor to the next since the symptoms began in 2003. It was in 2009 when the whole thing blew-up and no DOCTOR, I am not looking for pain medications, I am looking for some help!



I hope you never get diverticulitis. It is one of the mos painful problems I've ever had and that is saying a lot from someone that lives in chronic pain 24/7.

[Humanist_Activist]

64. Sorry for my ignorance, I didn't mean to sound flippant. n/t

[CountAllVotes]

67. Many people don't know what diverticulitis is

And yes, that included me.

I wish I'd known too. It could have saved me from being where I am today, a scarred up physical disaster-zone that doesn't really care to live a whole lot longer considering a colostomy bag could be in my future *again*.

There is no reason to apologize, it is not your fault. I had no idea either (found out the hard way I guess I'd say).

[Recursion]

27. Kind of depends on your doctor's time management and business model, no?

There's not a single answer to that.

[cherokeeprogressive]

29. Bingo. And I'm guessing it won't be "Come right in!".

[Niceguy1]

30. my clinic has an urgent care

Operation, which bills the same as if you were seeing your primary care physician. Its fast, too.

But I think your point is about access.. any good dr, or clinic doesn't accept more patients than it can handle. If yours takes on too many to see you in a reasonable time then you need to change to one that can. Which may be hard if the system is overloaded with new patients.

[LWolf]

36. Other.

I haven't had a doctor in 9 years.

I can't "call in sick." I get up, drive to work, arrive by 7, arrange for a sub and then spend 90 minutes writing sub plans and setting things up; then I drive to the local urgent care, wait 15 minutes or two hours, depending on the day, and pay them cash. Because my deductible is too high, so my insurance won't pay for it.

The next day I am at work for well over 12 hours, catching up on all the things that didn't get done that day, because subs don't do all the work, they just supervise the students.

Which is why, unless I absolutely cannot function at all, I'll go to work anyway and go to urgent care when the day is done.

[roamer65]

37. I have experience in this matter.

You don't go to your PCP. You get your butt into ER immediately. Then you get a CT scan done to make sure there is no perforation and if there is it's immediate surgery. If not it's IV antibiotics and bed rest, possibly a day or two in the hospital for monitoring. Peritonitis is not a thing to play around with and doctors do not like having to go in and clean it up.

[TBF]

38. "Wicked pain" is an emergency room visit Comrade -

if folks had tended to their issues all along with preventative care we wouldn't be in this boat.

Maybe your fear-mongering would go over better on a right-wing site.

[Nimyth]

43. Wiked Pain

If it is new yep E.R visit. Unfortunately for many of us 'wiked pain' is a daily fact of life- as much as I wish it were so medical technology does not have the cure for everything, there is no silver bullet or 'cure' for many things there is just learning to cope.

[roamer65]

44. Sadly, very true.

After a few days of oxycodone after surgery, I got off that stuff ASAP. I can't even imagine having to use painkillers like that on a daily basis...ugh.

[TBF]

47. I know -

I have arthritis myself. Before I figured out what was going on it wasn't so much pain but I literally had trouble getting out of bed and walking down the stairs (due to the inflammation). I was really stiff and couldn't figure out why my limbs wouldn't work.

It finally dawned on me that it must be my joints so I made an appointment with a rheumatologist. I am fortunate to have good insurance and I continue to fight for a single-payer health care system.

[NightWatcher]

45. Is this the rw "too many patients, not enough Drs" meme?

Just because people get insurance doesn't mean they'll all run to the Dr for shits and giggles. A lot of people already have insurance and don't flick to the Dr for every little thing.

[Sunlei]

46. wicked bad pain you go to emergency room. even then you may die even if the wait is short.

[cali]

52. that depends. I live with "wicked bad pain" every fucking day

and now I'm on a new medication and I just spent the morning in horrible pain and puking. called my doc, she called back within an hour and told me to stop taking it.

fuck.

[Sunlei]

61. I feel bad for you, good thing your Doctor called you back.

The weekend a lot of Doctors go missing and let staff handle everything. what are you in pain from?

[cali]

71. thanks.

CRPS- the result of smashing my leg to pieces. It took over a year and 3 surgeries to heal- lots of parts in my leg including a rod down the middle of my tibia and plates on my fibula. I was left with this:

Complex Regional Pain Syndrome (CRPS), formerly Reflex Sympathetic Dystrophy (RSD) or Causalgia, Reflex Neurovascular Dystrophy (RND) or Amplified Musculoskeletal Pain Syndrome (AMPS) is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS is expected to worsen over time.[1] It often initially affects an arm or a leg and often spreads throughout the body; 92% of patients state that they have experienced a spread and 35% of patients report symptoms in their whole body.[2] Recent evidence has led to the conclusion that Complex Regional Pain Syndrome is a multifactorial disorder with clinical features of neurogenic inflammation, nociceptive sensitisation (which causes extreme sensitivity or allodynia), vasomotor dysfunction, and maladaptive neuroplasticity, generated by an aberrant response to tissue injury.[3] Treatment is complicated, involving drugs, physical therapy, psychologic treatments and neuromodulation and usually unsatisfactory, especially if begun late.[4]

CRPS is associated with dysregulation of the central nervous system[5] and autonomic nervous system resulting in multiple functional loss, impairment and disability. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.

CRPS has the unfortunate honour of being described as being one of the most painful long term conditions, scoring 42 out of a possible 50 on the McGill pain scale, above such events as amputation and childbirth.[7] Lack of social awareness has inspired patients to campaign for more widespread knowledge of CRPS[8] and lack of clinical awareness has led to the creation of support groups seeking to self-educate with the latest research.[9]

http://en.wikipedia.org/wiki/Complex_regional_pain_syndrome

[CountAllVotes]

59. Yep

By the time I arrived at the ER via ambulance I had 45 mins. to live, that's right 45 whole minutes!

[Sunlei]

63. by my go to emergency and may die anyway statement,was thinking about my Dad.

[Spirochete]

48. mine would just send me

to the E-ward.

[WinkyDink]

53. It has been my experience that drs leave open certain times for such emergencies. But I live in an

area with a Brazilian amount of Urgent Care Centers, ER's, hospitals, doctors, etc.

[winter is coming]

57. When I had insurance? I would have called the doctor, and she likely would have told

me to go to the ER. These days? Nada.

[AtomicKitten]

66. This should be treated immediately

either at the MD's office or the ER. This is most often treated with a 3-drug regimen and bowel rest.