" An 'A-B-C' Of Home Health Care: A List Of Things You NEED To Know..."

  “ An ‘A-B-C ‘ Of Home Health Care: A List Of Things You NEED To Know ( Which Might Just Save Your Life, Or The Life Of Someone You Love ), Incomplete As It May Be…Still  “

Part I of IV

04/24/12

To my ever-caring, dearest friends and gentle readers, I find I often think of you, in gratitude for your having befriended me, and ever kept me from feeling quite so alone; you have been as a gift from God to me, and I, for my part, ever wish you well and safe from harm, with days of lessened, or of, ‘no pain’, surrounded by those who love you, with an ease of mind and resting spirit, free from care, and for all the happiness your kind, and loving hearts can hold.

I have thought long about how I might—in some, demonstrable way—send you my most sincere regards for health and happiness, and, in following that natural course of my concern, attempt to ever be of some, slight, genuine help to you, or to those you love. Then, my dearest friends, should that intensely thought-about help prove real, then, and only then is my heart truly happy within me. 

In order to be honest with you, for I would not knowing abrogate you kind trust, I first must preface all by saying that I am NOT a professional, nor am I licensed as a practitioner; I am not a nurse, nor doctor, nor technician in any particular field, so I would suggest to you to that, while my advice is based on demonstrated instances of fact, I would nevertheless ask you to seek legitimate care, by a legitimate Provider, to better answer your concerns, for you are right to have them; and should have them, if for no other reason than to support my arguments, or to clarify your thoughts.

I will say—though—that prior to my disability, I worked long years in the healthcare field, and from simple listening, studying, and reading the appropriate literature, I think I have picked up a few tips that nevertheless might help save your life, or the life of a friend or loved one; but, as such, I must deny any culpability that might otherwise land me in deepest, darkest shit.

However, I WILL tell you that everything I may say, has been tried with some previous success; and then, some of it should be common knowledge, to better help you to become more ‘proactive’ with your own care, and familiarity with your body, and how it works ( and, sometimes doesn’t ! ), only then can you forge a more successful relationship with your particular Provider.  Please do not take offense, but to be unaware, is to be ignorant and vulnerable; and for all my dearest friends who already have been diagnosed with serious conditions, whether mentally, or physically, or both, your needs will be better served by remaining well-read, and well-informed.

First, please allow me to begin with a condemnation of the healthcare system in this Country in general; too often, the ‘third-party-payer’ system, namely health insurance has proven itself to be a gigantic failure.  From unchecked abuses from within, and yes, by Providers who charge billions of dollars illegally, health insurance now has become a luxury that too many of our citizens cannot afford.

Each year, Medicare is hemorrhaged by fraud, deceit, and wrongdoing… costs that are passed on to the recipients; when instead, the A.M.A. should police its own, and Medicare should stop blindly paying out these exorbitant sums, and should—instead—actively seek to revoke an abusers Medicare billing rights, and prosecute the wrongdoers, with heavy fines, and prison terms, while the A.M.A. should get off its ‘old-boy-system’s ass, and start revoking licenses, and where possible, having the offenders deported from our shores, to deny, forever, their return.

At present, it actually requires a physician to amass such death, and miss-prescription sometimes via the good, old ‘sample’ box; or to routinely hand out drugs like candy, or to add to a hospital’s in-house mortality rate among its patients for botched surgery, and inappropriate surgery, and a thousand, other, wild wrongness before the A.M.A. will even begin to question a physician’s record; mostly, these horrible excuses for Providers that we naturally trust as being well-educated, licensed, and proficient in their specialties.

While it may be argued, otherwise, these ‘dangerous’ doctors are—at best—fined, and perhaps suspended for a while, instead of being tossed out in the streets to be had at by ravening dogs. Too, too often, the offending practitioner simply moves to another state, to set up shop again; licenses to practice allowed to continue.

In fact, my dearest friends, the very LAST time I heard of a doctor’s license to practice revoked was some years, ago; a local—foreign—physician became widely known for easily writing scripts for all controlled drugs, such as Morphine, Demerol, Xanax, and so on. 

( Patient’s (?), would go to him, pay for a visit, and come away with prescriptions for all manner of drugs, pain, and sleep medication; in the space of—perhaps—fifteen minutes, clients would happily exit his office, with the often repeated term, “ I got ‘em !.” Never were any tests done, or urine samples gathered.  In the fullness of time, this blatant behavior captured the interest of the F.D.A. as well as the F.B.I., and other, local law enforcement agencies.

Finally, this physician began to advertise in local, weekly papers that for, $50.00, he would write any prescription that was wanted; I even believe around the border of his ad, were listed some examples that were most readily available. Which included practically all narcotics, and opiates, and benzodiazepines, and more; clients who were in genuine pain were seen, chock-a-block with addicts, and recreational users and abusers of these drugs.  It was so easy.  He was, by then, so openly greedy, that finally, the A.M.A. intervened, revoked his license to practice, and had him deported back to India.  Its stupid stunts like that that go on and on before they are stopped.  Meanwhile, the natural consequences of this are: before they can be stopped, by agencies that move with glacial slowness, the population of recreational users, and addicts climb exponentially, while the patients who are legitimate, and in agonies of pain, find that access to the very medications that they need—just to survive—become increasingly more difficult to get, if not impossible.  That Pain Management Clinics and physicians are placed under a microscope (as are the patients), and while any physician can—I believe—prescribe narcotics, few to none of them do, for fear of getting into trouble. And most gratefully leave that to Pain Management, with all its attendant faults, delays, and frank suspicions, that—to my mind—place the genuine patient in the same league as the casual abuser.  How often has this unnecessarily prolonged the treatment process?  And, of course, as usual, it is we who suffer in the interim.

‘A few, personal thoughts:’

After decades of direct observation, it has become my humble opinion that healthcare in this Country is no better—now—than it was before the Great Depression of 1929, or earlier, say, just after WWI., for different reasons.

 When my father was a young child, the practice of medicine was often, ‘wait and see’; to be short and/or frank, in those days—for the majority of Americans—it was a coin-toss: either one got sick, and lived, or one got sick and died.

Millions of our people (besides those around the world) died in that great Influenza epidemic just following WWI.  There were no antibiotics then, and nothing to reduce fevers, saving aspirin, which had been around since 1890.

Certainly, since then, enormous strides have been made in the diagnoses, treatment, and progress of disease.  X-rays, circa 1928; penicillin, discovered shortly before the outbreak of WWII, and so on.  All these new ‘miracle’ drugs and inoculations, and things such as specialized scans, etc., resulted in the practical end of pneumonia, syphilis, polio, and were the products of hard science, investigation, experimentation, the occasional flash of genius, such as the discovery of sonograms, CT scans, and M.R.I’s.  All helped alleviate illness, and prolong life.

During WWII, my father, having been severely injured in combat, was given the latest wonder then: penicillin.  But so new was it, that no one had yet discovered ways to ‘titrate’ ( or, balance) the dose, so that he, along with hundreds of thousand G.I.s, had their battle-field infections cleared, but who subsequently developed life-long allergies to all the ‘cillins’.

But I would ask you, my dear, dear friends, of how much benefit can these resources be if no one can afford them?  Those without health insurance are doomed to a life of needless suffering, and death, or pay exorbitant prices for health insurance that has limitations, requiring one to HAVE to choose a Provider ‘within network’, or one that has horrific co-pays that many cannot afford.

Those who must—perforce—labor at substandard jobs, or, ‘slave jobs’ as they’ve come to be known, should these employers provide even some health insurance, the employee will still see the premiums jump into the stratosphere for additional spouse, or dependent coverage; and frankly, friends, what dental insurance they tack on is hardly worth shit.

And, please allow me to provide you with a chilling caveat: I am now on Medicare, with NO secondary insurance.  Should anyone think that I am on the ‘gravy train, with biscuit wheels’, I would kindly ask you to reconsider.  Under Medicare guidelines, I cannot go to a dentist to have a single tooth x-rayed, treated, or pulled; but Medicare WILL pay, if I have ALL my teeth pulled, and will provide me with one, lifetime set of dentures.  So much for that errant cavity.  I imagine that many of us have dentition problems, infections, impacted wisdom teeth, and suchlike. Again…but who can afford to go?

 What we NEED, is a comprehensive, National Health scheme such as they have in Canada.  Will we ever have one like it, or even, remotely like it?  No, not as long as such egregious abuses remain.  Not as long as a single Tylenol given in the Emergency Room costs about $5.00.

But I fear, my very dearest friends, that I am swaying-off topic, which was to provide you with a few, basic things you NEED to know.  While I meant them to be rather neat, and alphabetical, I’m sure I’ll tend to veer, but I shall try to pause, and take a needed breath, and marshal what thoughts I do have which I hope may prove to be of some, small help to you. 

I shall not lie to you, nor conjure things out of mist and smoke, but, rather, leave my saber-rattling for another time’.  Please know the following things are—in the main—self-evident, if only you but pay heed to them.

It is a measure of how very much I love you.  Please know that.

Should you have further questions, please do not hesitate to speak of them to your Provider, your pharmacist.

Or, should your complains warrant, I would urge you to go IMEDIATELY to your nearest hospital ER, or call ‘911’ if you are unable to get there under your own power.

Before I do get started, should you already be on medications, become familiar with what they’re supposed to do, their potential side-effects, and what to look for, and please always take them as prescribed. Never take another’s medications, nor share yours with another.  Always, keep them out of children’s reach, and away from those who might be nosey.

Make a list of everything you are taking, whether prescribed, over the counter, supplements, vitamins, even.  Make several copies of one, concise list; keep one list with your medications, perhaps, one copy folded-up in your wallet or purse, and even one in the ‘glove-box’ in your car.  Make doubly sure each physician or Provider you see has a current copy.  Update the list, whenever changes are made.  List when you take them and for what purpose, and by what prescriber.  Please list all allergies you have to everything, especially medication.  And while the list does not necessarily have to be alphabetized, it nevertheless is a great help (especially by anyone, say paramedics) who have little time to glance at them, to group like medicines together; thus, all psychotropics are listed together.  Then a space.  Then, all medical meds.  Then pain medications, whether opiates, or benzodiazepines.  Then, over-the-counter medications.  Then, those medications that are taken on an ‘as needed’, or ‘PRN’ basis.  Then any supplements that you may take, and so on.

Also, mention whether you smoke cigarettes or not, and about how many a day.  Be honest, especially if you may smoke a lot, or already have C.O.P.D.  (Chronic, Obstructive Pulmonary Disease, as so many of the narcotics and opiates are respiratory depressants,  that might make breathing difficult).  And then, surgeries you may have had, and when.

Granted, the formulation of your medications list may take some time, but will be worth its weight in purest gold, especially during the so-called, ‘Golden Hour’, that time while, if in trauma, and immediate treatment, your chances of survival are good. Or, during which more rapid intervention might keep you from dying from a stroke or heart attack.

Well, my dear friends, it would appear that the ‘A-B-C’ list, shall have to wait until Part II.

Forgive me, please, for I am exceedingly tired tonight, and—as is my want—am hurting in a hundred places; this makes what I’ve so far said a tease of sorts, but, I would rather be in sharper condition, as to not misspeak myself.

And so, my ever wonderfully kind and caring friends, and loyal readers, as always, I wish for you ‘no pain’.  I wish you health, and greater self-empowerment.  As well as quiet, contemplative days, and evenings, full-surrounded by family and true friends who love you and care for you.

I wish you blissful, quiet nights, free from worry or distress, and a gentle calming into glorious, pain-free sleep, free from nightmare’s awful sway, and protected—and kept safe—by the ministerings  of gentle angels.

End of Part I of IV; Part II to follow.

My dearest friends, and patient readers, please know I love you dearly,

‘Zahc’/ Charles