Article 25

Pain in the Butt

In Uncategorized on 04/05/2013 at 2:34 pm

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Pain in the Butt

A look at health-care access and one poor sore arse

By Gregory Flannery

 

First stop: Emergency room at a Catholic hospital, which treats the patient and diagnoses him as broke, giving him a 100 percent discount. He also receives directions to a publicly funded hospital’s indigent-care program for further treatment.

Second stop: Business office of the publicly funded hospital, which diagnoses the patient as insufficiently poor for the indigent-care program. But it offers a convenient payment plan: $957 down and $109 a month for nine months.

Third stop: Emergency room of the publicly funded hospital, where the patient apologizes to paramedics for the blood he’s left on their gurney.

“We’ve seen worse,” one says.

This isn’t about my ride in an ambulance or later atop a bedpan, though both were personal firsts. This is about the health-care maze, a travelogue of confusion, compassion and cash.

Red letters

March was National Colorectal Cancer Awareness Month; and with that as cover, I will tell you that I had been bleeding out the ass for quit a while before finally going to an emergency room. Thus I embarked on a course that – remembering National Colorectal Cancer Awareness Month is barely behind us – should scare the shit out of anyone lacking health insurance.

I am such a one. I lost my job and my health insurance in December 2010. My unemployment compensation expired in May 2012, a month after I first noticed the bleeding.

Six months later I went to the emergency room and was told to get a colonoscopy. The procedure isn’t uncommon. Nor is it inexpensive.

The publicly funded hospital sent me paperwork to apply for financial aid. The envelope bore this message in red letters: “Urgent request for information.” It took a month to learn that my wife earns $500 a year too much for me to qualify for indigent care, which clearly wasn’t as urgent as the envelope seemed to indicate.

This was curious in part because another member of our household receives indigent care for a chronic condition through the same publicly funded hospital, based on the same income my wife earns. All indigents are not created equal.

Friends proved helpful in ways that made me feel far better than a man with bloody stools ordinarily would. One found a “discount colonoscopy” service – $950 for the whole package – and offered to pay the bill.

Another friend consulted her own doctor for ideas.

Months passed. New symptoms developed. The emergency room at the Catholic hospital saw me again and provided a list of local hospitals that could help an unemployed, uninsured person get treatment. One after another, each social worker at each hospital referred me to the publicly funded hospital.

Friends sent money, sometimes anonymously. Friends loaned me money. Thanks to them, I received a colonoscopy in late February.

Sorry, my ass

The one-gallon medication that must be drunk before a colonoscopy – guzzled, in fact; consumed within four hours – is cleverly called GoLytely. A more apt named would be GoForcefully or GoMoreThanYouThoughtPossible. I hoped there would be an established record for most colonic evacuations and that my own performance – 34 in 10 hours – would rate a prize. Or perhaps a discount in the Catholic manner. So far I have found no record. I believe that makes me the first winner.

I whined endlessly about my fear of pain during a colonoscopy, and everyone who had experience with the procedure ­– doctors, nurses, persons who had had colonoscopies – assured me that I would neither feel nor remember anything. The nurses said I would be administered an “amnesiac.”

There came a moment during my colonoscopy when I woke up and saw the Butt Cam in action. The screen showed a whitish oblong growth on my innards. I noticed there were two more people in the room than when the procedure started. One said, “You’re going to have to take it off in pieces.” I decided I should go back to sleep, and did. The amnesiac didn’t work, but the knockout drops were wonderful.

A doctor later told me that most polyps are the size of sesame seeds but some of mine were the size of almonds. Is there a record for this?

That would be the end of this tale of woe but for the fact that after I got home, I started bleeding buckets. Well, maybe not buckets, but I could have filled several multi-serving Tupperware containers.

My wife was driving me back to the hospital. We were on I-74 near Beekman Street when I  asked her to pull over. I knew I wasn’t going to make it. When we called for help, kind paramedics from the Cincinnati Fire Department picked me up.

One thing led to another and I ended up in intensive care. When a doctor ordered a follow-up colonoscopy, I began another round of GoLytely. Then a surgeon “on rounds” happened by and said to the intensive-care nurse, “Do not let them scope this man again. If they try, contact me immediately.” He pointed to me and said, “It’s your body. Do not let them do this to you. There are risks, and no benefits.”

Grateful not to have to finish a second round of GoLytely within 24 hours, I no longer cared whether I might have beaten my own record.

I told a nurse who empted my bloody bedpan, “I’m sorry for the mess.” He said, “My patients are not allowed to apologize. I’m just doing my job.” Later, when he had to put a needle in me, I winced. He said, “I’m sorry.” I told him, “My nurses are not allowed to apologize. You’re just doing your job.”

The next day a team of four doctors came to my bedside. The one who seemed to be in charge said, “We apologize.” I’d been up too long and made too many record-setting visits to the toilet to ask what they were apologizing for.

So it’s over now.

My polyps were “pre-cancerous.” But they were also many, and the rest need to come out soon.

The publicly funded hospital has meanwhile referred me to its internal-medicine clinic and sent me an application for the indigent-care program. It arrived in an envelope that bore this message in red letters: “Urgent request for information.”

The city of Cincinnati also sent me an application for indigent care. That ambulance ride isn’t free, you know.

A song is born

Hamilton County voters repeatedly approve a property tax for indigent care, providing basic medical care for people who can’t afford it. But the potential demand is greater than the available funds.

In Ohio, Medicaid is limited to people of low income younger than 18 or older than 55 or disabled. I am 54, and my only disability is hearing loss so severe that my right ear serves a merely decorative purpose – a condition that I contend should give me special parking privileges but which are not yet provided under existing law.

My friends saved my life. When I told them so, they demurred. But the doctor who told me my munificent almond-sized polyps were “pre-cancerous” said they would have become cancerous if they hadn’t been removed, which only happened because my friends financed it.

Hoping to make some contribution to the debate over universal health care in the United States – first proposed by President Harry Truman more than 60 years ago – I wrote and produced a music video. The refrain:

“Baby, kiss the booboo on my poor sore arse.

It feels like it’s been dipped in Tobasco sauce.”

Next year the Affordable Health Care for America Act (aka Obamacare) takes full effect. The law is far from perfect. Instead of providing health care for all Americans, it requires all Americans to have health insurance. It’s at least a first step.

Health care can be a messy business. A few days after I got out of the hospital, I had to clean up the pool of blood on the passenger seat of our car. It had clotted, and I worried that someone in a parking lot would see it and call the police. I’d had enough hassle already.

The paramedic was right when he told me, “I’ve seen worse.” People die of gunshots and hangings, for want of medical care, for want of food, for want of love.

Before losing my job in 2010, I worked full-time for 35 years, with a couple years off due to unsuccessful union-organizing drives at newspapers, which, as is well known, employ persons largely unable to tell their asses from their elbows – i.e., reporters. During those 35 years (which I hope will soon turn to 36 and more years), I paid taxes to build a football stadium and a baseball stadium, to pay for large corporations to get tax breaks if only they stay in Cincinnati, to have an outstanding zoo, to have an outstanding Museum Center. And that’s just some of the local stuff.

I’ve also paid taxes for social security and Medicare for our elders. It’s what civilized people do.

Do I believe I’m entitled to medical care – that we all are? You bet your ass I do.

I’ve already bet mine.

 

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  1. Bum bum? Bummer!

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