Hospirals & Health Care--Inside View

During the past 6 months I've been in 2 emergency rooms, 2 hospitals, undergone 2 surgeries, and am now facing time in a rehabilitation center which I think is a politically correct term for a nursing home. You learn a lot from inside this prism; here are some observations which are purely my opinions.

I have Medicare A&B, and AARP Plan F supplement through United Health Care along with a prescription drug card. The total cost is $340/month. My out of pocket expenses with this coverage have been minimal; except for co-pays on some drugs they have been zero. While I may not have access to every health care provider in my world there are plenty readily available. Having affordable health insurance, minimal co-pays and facility access eliminate lots of concern. My premiums do increase each year but they have been reasonable. Someday this system will totally implode, but probably not in my lifetime.

Health care providers have to follow many procedures, aka government regulations. It sometimes means waiting time, cant do that until we do this, etc. I also think since providers know they won't get the dollars they bill, they look for ways to increase volume with approved Medicare procedures. I've said it before, no individual really ever knows the true cost of their health care. Ever since doctors lost control no one really has control anymore. However, if the US ever completely turns it over to government control, costs will soar and quality will no doubt suffer. Ever wonder why the 3 branches of federal government completely remove themselves from traditional medical health care systems? I don't.

When you're in ER and/or move to the hospital more than one doctor may be managing your situation. That can quickly complicate matters. It is important to remain calm, ask plenty of questions as politely as possible. Usually you'll notice when they come talk to you there are 2 of them present so stuff doesn't fall through the cracks; it still can happen. Do your best to comprehend, and even when you think they are full of shit, your best response is "I'm not sure I understand the part about xxx, could you go over that again, please." I'm not the most patient person, but I am one the most stubborn so this lesson has been difficult for me. Learning to blend those characteristics into "determination" is one of my life goals.

Ever since I accidently overdosed on Vicodin to complete a century ride with broken ribs in 2007 I pay a lot of attention to pain medication management. Having overcome an alcohol problem a few years ago I don't want to develop another addiction. During the last few months I've learned that when you are in acute pain, medication is good. When needed make sure the providers know your complete health history and all medications you have been taking. Most problems arise when multiple meds, alcohol and other stuff get taken in unsupervised combinations. If possible use one pharmacy for medications and remember a good pharmacist is a valuable consultative resource, in spite of the internet. Of course being the son of a third generation druggist has somewhat prejudiced me.

Go to an ER when you wind up laying in the road after an accident or other similar potential life threatening situation. On the way, hope you will not be their top priority. Once you arrive and it's confirmed you are not, your goal is to get out of there ASAP. If you wind up in a hospital, your goal is to get treatment and get out of there ASAP. I'm sure it will be the same in the rehabilitation facility. The important goal is to move forward even if progress sometimes seems negligible.

I am anxious to get back to normal and on my bike again. It's been said this kind of stuff happens in threes; I hope my Paris-Brest-Paris incident and these 2 accidents mean I'm done with these encounters for a while.

Bike Accidents--Update

On September 9, 2013 I wrote about the bike accidents I had in over 50 years of cycling. Unfortunately that now needs updating. I've had 2 crashes that landed me in an ER; both involved fractures. One occurred on September 28th on a Randoneur ride which started in Rome. Despite a fractured femur I did a 200 km ride 4 weeks later. Details of that are in a post dated October 26.

On Saturday while doing a 115 km Rando event I crossed railroad tracks and managed to drop my front wheel into a wide gap. The tracks were at an angle and I lined up on the right side of the road to cross them perpendicular as I've done thousands of times. A car passed me going in the same direction and I was paying more attention to that than the tracks. A wide gap grabbed my front wheel and I went down on my left side. That earned me an ambulance ride to Atlanta Medical Center where after 5 hours of x-rays and CAT scan I was diagnosed with a displaced left clavicle fracture, concussion and a hip pointer.

They elected not to do surgery on my clavicle then, but a follow up discussion with the ortho doctor who has done work on me before led me to conclude surgery is the best option for me. Trying to wear a clavicle brace that I could not take off or put on myself turned out to be too uncomfortable; and this opinion from someone who knows how to manage pain. I hope to be back riding on the road soon, but will have to figure out that timetable after surgery which is scheduled for February 12.

My observations haven't changed from that earlier post, but I would add one. Emergency rooms are the place to go for true emergencies. However, your care is prioritized by the level of trauma, not only yours but in comparison to every other patient. That's not a complaint; that's how it should be. For me that translated into first class quick treatment in Rome on a relatively calm day in their ER, compared to a 5 hour wait at Atlanta Medical Center on an evening they were also dealing with 2 fatalities. I was grateful not to be a level 1 trauma.