Oh. just when I wonder when my personally paid (and not tax deductible) health care insurance premium will provide me with access to necessary orthopedic treatment ....
I remember that Medco (the large pharmaceutical company that destroyed Medical Part D and has left elderly patients frustrated by CEO David Snow's requirement for "pre-approval" after a doctor has already written a script and requires that the elderly pay full price if the doctor believes a more expensive medicine is safer) is salivating to be the single payer in Obama Care.
Medco and its money hungry (at the expense of our nation's senior citizens) CEO David Snow, Jr. made sure that he got his "girl" into the Obama "group 'o czars." He name is Nancy DeParle and Nancy was fortunate to be named a member of the Medco BOD last Fall. My best guess is that Snow elevated Nancy when it became clear that flunky Tom Daschle would never pass through the confirmation hearings. The concept of taxes is too tough for these politicians and yet they purport to know how to "save" health care for us all?
None of us get to know the connections and potential conflicts that exist in Obama's czar system. Well, good people of America, there is a real bias and potential for over-reaching when a member of the CEO of Medco (the company that runs Medicare Part D) is Obama's health care reform czar! Even her White House resume leaves out the connection with Medco! Why?
This renegade Obama Czar system is wrong and in the context of health care, it is sneaky and inappropriate.
Medco is pushing as hard as it can!! http://www.makingmedicinesmarter.org/
According to the web-site,
Medco has built this site to advance the dialog on healthcare reform. Because we feel that fixing healthcare is not about spending more, but spending smarter. Because smarter simply makes healthcare better.
Medco is a company that is less interested in helping Americans and more interested in advancing their corporate interests. What out for the Medco/Obama Care connection. Ask questions. Learn about Nancy DeParle.
My dad is a strong man. The fact that he has survived the repeated errors and mistreatment by physicians speaks volumes about is inner strength and motivation to live.
The errors and mistreatment has been exclusively by Duke University Hospital "stranger doctors" (hospitalists). The medical care that my dad has received by Duke Clinic physicians and surgeons (I used to know these professionals as part of "Duke Private Diagnostic Clinic") has been terrific.
Whenever dad gets tired and seems to lose the motivation to survive, I remind him that the doctors that know him and treat him routinely have never screwed up. I have these conversations with my dad because he begins to wonder whom he can trust. Dad needs to know that his Duke Clinic endocrinologist, gastroenterologist, cancer surgeon, oncologist and orthopedic surgeon have been top notch.
Trusting your doctor is essential.
My dad does trust his Duke Clinic doctors and he encourages me to continue my campaign to expose the Hospitalist Program Model as dangerous for patient safety.
Today my dad was (as usual since the placement of the external fixator) in a great deal of pain. I stay at home with him and try to keep his mind off the pain. We talk and play games.
But today was a tough day for dad. My dad was trying desperately to help me feel better. And dad does not know how to help me because he has seen me hurt and in pain for literally years. On Saturday July 4, I tried to climb a ladder to raise the American Flag. Both when I raised the flag and then much worse when I lowered the flag, my left knee buckled, I lost my balance and fell to the ground. My leg and ankle are very swollen.
It hurts my dad because he knows that I work tirelessly to make sure that he gets the best medical care possible. And, there is nothing that dad can do to help me get medical care.
Oh, Mr. Obama. The medical care crisis is not about access to medical care through insurance! That is just plain silly. IMHO, I was injured by an orthopedic surgeon associated with Carle Clinic Association in Urbana, Illinois (Chris Dangles, MD) when he admittedly stated under oath that he did not know why he performed surgery on my ankle. That was in 2000.
Almost nine years and four corrective surgeries later, I still cannot run. I still lose my balance when I push my dad in a wheelchair. And I fall to the ground and lose consciousness while my helpless and scared dad is in a wheelchair.
When I regain consciousness, I see the feel and embarrassment and tears in my dad's eyes.
I have health insurance. I am part of the high risk pool for the medically un-insurable in North Carolina. That is what happens to those of us with cancer. We are responsible enough to get insurance. Being insured is a choice, Mr. Obama. Being insured does not guarantee access to health care!
(One of) the problems with the medical system is that doctors hurt patients and then there is no accountability. Dr. Dangles continues to practice orthopedic surgery in Champaign, Illinois, and I am unable to walk without pain, push my dad in a wheelchair or even hang the American Flag.
Moreover, Dr. Dangles reduced me to a cripple who suffered daily pain and depression while I tried to practice law. His colleague at Carle Clinic (psychiatrist James Whisenand, MD) had me on so many medications so that I would not be sad or scared that I was numb and unable to function cognitively. Great. Carle Clinic had me physically unable to move and cognitively unable to think straight.
In large part, Carle Clinic contributed to my inability to practice law. (Which gets me to the issue of how many attorneys do not really represent their clients - my attorney to try to save my law license refused to allow me to mention the impact of the surgeries and drugs. According to Attorney William Moran, III of Springfield, IL, mentioning those factors would be "making excuses" and "not taking responsibility for my actions and mistakes."
Okay. I took responsibility.
What about the doctors who mess up? How is Obama Care going to handle that?
Today as I was wrapping my leg so that I walk to the kitchen and make dad lunch, my dad asked me to contact the orthopedic surgeon's office in Chicago and find out if he could help me. Dad also wanted me to contact my (and dad's) Duke Clinic orthopedic surgeon and ask for his assistance in communicating with the Chicago surgeon. Dad wants to trust doctors and I did as he requested. What a waste of ink.
All of the medical insurance in world cannot make a surgeon or physician care about a patient if they don't. How is Obama Care going to ensure that patients are not left damaged for 10 years by orthopedic surgeries?
As I helped dad get settled for bed, he can see the pain in my eyes. He knows that my leg and hips are in great pain. Dad asks me whether anyone from Duke called and offered help for me. I have never lied to my dad. I cannot start now. But I still want dad to trust the Duke physicians and surgeons that abandon me. "I am okay, dad." "We will worry about that in the morning."
As I do every night,
I ask my dad "who is my hero"?
Tonight, dad replied "You are my hero."
I hugged dad and repeated "But who is my hero"?
My dad smiled broadly and proudly said "I am your hero."
Happy July 4. Remember what the founding fathers wanted for this country.
I sometimes wonder what the founding fathers would think of how we are doing with the country. I regret that I believe they would be disappointed in us.
Obama is taking our country in a direction that is absolutely contrary to what our founding fathers wanted!
(1) Where is our ability to determine the direction of our own futures?
(2) Where is the personal accountability of professionals (Attorneys, CPAs, physicians) who make mistakes? When a doctor makes an error, it is all a big joke.
(a) No one at Duke gives a hoot that they destroyed the lives of my dad, mom and myself. Duke is cool with damaging my dad by their mistakes so long as I do not sue them.
(b) No one at Carle Clinic gives a hoot that its orthopedic surgeon (Chris Dangles, MD) performed by his own sworn admission unnecessary surgeries on me or that its psychiatrist (James Whisenand, MD) had me doped on entirely too much medications for a wide range of psychiatric disorders just to calm me down but without recognizing the effect of those drugs on my post orthopedic surgery body, Carle Clinic just allows their orthopedic surgeon to disclose my protected mental health records as a defense and to intimidate me from proceeding with a law suit.
(c) No one at the law firm of Erwin Martinkus and Cole (specifically Lynne Feldman and Raymon Michael Brown) give a hoot that they lied directly to the IRS, devised internal accounts to hid money from the IRS and then ignored the IRS when they where told by the IRS that the treatment of me was legally wrong. The result --- I end up with a federal tax lien based wholly on the lies that Attorney/CPA Mike Brown told the IRS.
What has happened to my country? Have we let too many foreign people in to our country that don't share the same values as our founding fathers. People who prefer how Europe is run should move to Europe and STOP forcing the USA to be like other countries. This is our country. Just the way it was intended.
I am disgusted that this purported nurse of Michael Jackson is talking about requests that Jackson apparently made to the nurse for the drug Dipravan.
HIPAA is a critical requirement for the privacy of patients. The duties under HIPAA apply to nurses and they survive the patient's death. This nurse should be disciplined.
I am also disgusted to hear the doctors on television talk about how the medical professional is self regulated. It is not regulated well. There seems to be an acknowledgment that the doctors surrounding Michael Jackson had suspect pasts and some had even lost their license.
Medical costs would stop rising uncontrollably if in fact the medical professional was regulated. Self regulate, docs. I don't care how you accomplish it - but regulate your profession. It is ridiculous that doctors just shrug their shoulders while their peers (doctors) demonstrate incompetence and cause damage to patients.
Good docs "just want to practice medicine" and pretend HIPAA violations do not happen.
One of my favorite physicians (orthopedic surgeon) Mark E. Easley. MD told me on the very first day he met me in 2002 that orthopedic surgeon Chris Dangles, MD mistreated me. What followed for me was multiple reparative surgeries and HIPAA violations by physicians in Illinois. No, who exactly was regulating the medical profession?
Dr. Chris Dangles (Carle Clinic Association in Urbana, Illinois) performed unnecessary and painful surgeries on both of my ankles. The surgeries failed. Dr. Dangles claimed under oath that he did not know why I wanted the surgery - I (the patient) talked Dr. Dangles into performing the surgery. Meanwhile I was unable to ambulate and I was in horrific pain.
I hired a man who at that time to help me in my office because he was unemployable with a serious mental disease. I wanted to help him. That frankly caused me even more stress. My employee was embarrassed that I was unable to move and he actually scheduled client appointments hours after my surgeries.
I was also starting to suffer depression. The Carle Clinic psychiatrist (James Whisenand, MD) continually prescribed multiple strong medications that tranquilized me completely until I could think and I was hallucinating. I was concerned that I could not properly practice law. I asked Dr. Whisenand. He said I was fine and kept giving me drastic medications.
It was not until I began seeing Keith White, PhD at Carle Clinic Association and I stopped treating with Dr. Dangles that my life took an upward turn. Dr White helped me overcome the need for all of the meds that the psychiatrist was doping me up on and Dr. Easley was trying to correct the damage caused by Dr. Dangles.
But when I sued Dr. Dangles, I learned how protective the medical professional was for one another. Dr. Dangles gave all of my mental health records to his medical malpractice law firm as a defense to my orthopedic malpractice case. That seems to be a clear violation of HIPAA. Then, after it became clear that I could not practice law and I faced disciplinary consequences, the ARDC hired psychiatrist Dr. Stafford Henry to examine me and report back to the ARDC.
I gave Dr. Henry permission to report back to the ARDC BUT I gave no one the permission to further publish my medical and mental health records to the public Internet. That seems to be a continuing HIPAA violation.
I even asked my professional defense attorney at the time William Moran III of Springfield, Illinois (IMHO, Mr. Moran is light weight who has inappropriately close ties with the ARDC & who treated me as though he was prejudiced against an attorney with depression) why my mental health records (and even factually incorrect statements therein) would be on the public Internet forever!?
Attorney Bill Moran of Springfield, Illinois actually told me that it was more important to warn and protect the public against me FOREVER than it was to protect my privacy. Yes, you readers are correct. It did not sound like Attorney Moran was not really representing me.
Finally, after Dr. Dangles testified that he did not know why I wanted the surgery & he believed that I fell down post surgery because I have an alcohol problem . . . my trusted surgeon Dr. Mark E Easley told me that he "did not want to get involved" and would not testify in the case against Dr. Dangles. Dr. Dangles' testimony seemed significant to me but not apparently to his fellow medical professionals that are entrusted to regulate their own profession.
Shortly after that date, Duke University Medical did all but "no care" me. I guess I was somehow perceived as a "trouble maker" since I was injured and thought that a (non Duke) surgeon should be held accountable.
1. Mark E Easley, MD knows I am in pain and as far back as December 2007 recommended a surgical procedure that he could perform that would relieve the pain and allow me to live more normally.
2. By Spring 2008, Dr. Easley denied ever suggesting surgery (I'm glad my mom was with me in December 2007) and Dr. Easley recommended that I be seen by a Duke Sports Medicine surgeon, Alison Toth, MD.
3. At the initial meeting, Dr. Toth (who is also the womens team doctor) assured me that she could help me. But Dr. Toth wanted me to be seen by an anesthesiologist to perform diagnostic shots. Dr. Toth also explained to me that she would cut the saphenous nerve during surgery.
4. I underwent the shots with the anesthesiologist (Dr. Dianne Scott). Some of the shots were very effective and therefore good diagnostic tools. I told Dr. Scott that Dr. Toth was going to cut the saphenous nerve. Dr. Dianne Scott told me to not let her do that.
5. I sent several faxes to Drs. Easley, Toth and Scott and asked for a clarification about the cutting of the nerve since there was a disagreement between Toth and Scott. The only doctor who contacted me was Dr. Scott. That doctor had the decency to call me personally and say that she stands by her opinion not to cut the nerve and she explained the reasons.
6. Instead of calling me back herself, Dr. Alison Toth's office manager called me back and told me that Dr. Toth would no longer be my doctor. Period.
7. I don't know why . . . but Dr. Easley won't help me. And Dr. Toth abandonned me.
(a) Drs. Easley and Toth both know that I am in pain everyday.
(b) Drs. Easley and Toth both know that I have difficulty sleeping because I cannot put any pressure on my left side (from the hip down).
(c) Dr. Easley knows that within the last two months, I have lost my balance die to pain in my left knee and the loss of balance has caused me to fall, hit my head and suffer LOC.
8. I still cannot walk without losing my balance and being in pain. I cannot run. I cannot ride a bike. I cannot even swim.
9. I am hoping and praying that a well renowned orthopedic surgeon from Chicago can help me.
And, again, who protects the patients? And, again, how the heck is Obama care going to resolve the issues of lack of transparency and accountability in the medical profession?
The Duke University Hospital website claims to be concerned with patient safety. [See below] And, I am sure that conceptually, the staff and administration would indeed prefer that a patient did not slip on a banana peel in the hallway. But beyond the obvious, I have experienced the pre-hospitalists program model quality of care at DUH and I have experienced the post-hospitalist program model quality of care.
My life was saved at Duke University in 1985. The surgeon was Dr. William Peete. He recognized a condition that other surgeons and physicians throughout North Carolina had missed my entire life and, most dramatically, since a patched emergency surgery in Greensboro in 1982.
Dr. William Peete spent the time with me and my family to explain my condition. I was born in 1962 with entirely too much intestines and none of the intestines were attached to the wall of my abdominal cavity. I had been suffering my entire life with stomach aches and vomiting but my GP in small town Cary dismissed the problem as "nerves."
I almost died in 1982 when I was an undergraduate student at UNC-Greensboro. My abdominal cavity was swollen so badly that I literally could not stand up. I crawled to the UNC-G infirmary. The nurses placed me in a room and told me not to cry because I was bothering other patients. Two days later, a doctor said that I needed to go to the hospital. I was transported via UNC-G van to Moses Cone Hospital in Greensboro, NC. All I was wearing was a long tee shirt and socks.
The surgeons told me that the condition was too serious to wait for my parents to arrive from Cary. I was about 30 minutes away from dying.
I survived the emergency surgery in Greensboro but for the next 3 years I continued to suffer with nausea, vomiting, pain.
It was not until 1985 when my family got a referral to Duke University Medical that my life would be changed and saved. In 1985, Duke was a place of miracles. The surgeons and physicians were all remarkable. Duke did not accept every case. I could only been seen there with a referral.
Now sadly Duke Medical has become as any other medical institute --- a place where patients too often come second to money.
http://www.dukehealth.org/AboutDuke/quality/initiatives/patient_education_and_feedback_initiatives
Patient education and feedback initiatives to improve patient care quality and safety at Duke include:
Heart attack-specific discharge instructions and patient education information are composed of a 30-minute discharge video, a resource guide given to patients to help them manage their care at home, and one-on-one instructions from nurses before patients leave the hospital. The information answers questions heart patients may have regarding medications, risk factors, signs and symptoms of problems, and resources available at Duke.
Heart failure-specific discharge instructions and patient education information are composed of a 30-minute discharge video, a resource guide given to patients to help them manage their care at home, and one-on-one instructions from nurses before patients leave the hospital. The information answers questions heart patients may have regarding medications, risk factors, signs and symptoms of problems, and resources available at Duke.
Innovative motivation tools encourage patients to aid in their own healing process. In one instance, patients are given laminated dogs to walk to the nurses’ station three times a day. While the activity is fun and playful, it encourages post-operative patients to get their blood moving after surgery and thus avoid major complications.
Patient advocacy and support groups encourage patients and families to participate as active members of the health care team. Local patient advocacy groups, such as the Cancer Support Group, provide support to families and patients with specialized needs and concerns. The Duke Patient Advocacy Council is a group of patient volunteers who meet with Duke leadership on a routine basis. The Council’s mission is to provide patient perspectives and voices to Duke Medicine with the goals of enhancing patient-centered care; respecting the needs of the human spirit; and bringing together patients and their caregivers as partners in healing, education, and research.
Patient communication boards in patient rooms tell patients who is assigned to their care on every shift and how to contact their caregivers for assistance. The boards may also show other information related to the patient’s care, such as daily procedures.
Patient education materials consist of pamphlets, videos, and other sources of information that help patients manage their care and live healthier lifestyles.For example, Duke HomeCare and Hospice provides take-home materials that empower families and caregivers when they must administer medications to patients in crisis symptom management situations. This education gives families confidence and helps reduce medical errors caused by anxiety.
Patient rounding calls for a hospital unit or department leader to visit each patient within the first 24 hours of admission or transfer. The visits give patients the opportunity to provide feedback and resolve any problems they may have with their treatment.
Patient satisfaction surveys are given to patients on discharge to help us understand what patients liked and didn’t like about their hospital experience.
Pneumonia-specific discharge instructions and patient education materials have been created by the Duke health care team for patients who are receiving treatment for pneumonia. Health care providers discuss these educational materials with patients and their families during their hospital stay and before they are discharged.
Smoking cessation programs and patient education materials make it easier for patients to quit their tobacco use. They may include resource materials, classes, counseling sessions, and/or nicotine replacement therapy.
Surgery-specific discharge instructions and patient education materials have been created by the Duke health care team for specific types of surgeries. Health care providers discuss these educational materials with patients and families during their hospital course and before they are discharged.
One of the toughest parts of caregiving is watching your loved one suffer and you feel helpless. My dad has been suffering with remarkable pain with his external fixator.
Sometimes when my dad is in a lot of pain, he loses some cognitive and mental function. Through the two plus years that I have been with him 24/7, I have come to understand that a great deal of his temporary lost cognitive and mental function is due to stress and fear.
My dad has not been scared once since the external fixator was placed. He has absolute and unconditional trust in his orthopedic surgeon (Mark E. Easley, M.D.) and Dr. Easley's team. You really cannot minimize the importance of the patient trusting his medical team. I am pretty sure that Dr. Easley or his team could tell dad that he had needed to wear dangling crystal earrings in order to fix the leg and my dad would do it!
The tough part of caregiving is when you have to go through nursing staff and PAs to get pain relief for the elderly loved one. I completely get that the standard line is to get patients off of medications like narcotic pain medications fast! But pain is a vicious cycle. If the pain prevents the patient from getting a restorative sleep then the patient is more sensitive to pain and then the sensitivity to pain
prevents the patient from sleeping.
Many elderly persons have difficulty talking the newer class of sleeping pills (like Ambien). My dad sleep has a history of sleep walking while on Ambien. And our home has about 20 large brick steps leading out the front door. Oh, that would not be pretty.
I talked to the orthopedic nurse about a long lasting pain medication on Tuesday of this week. I left a message on Wednesday and I spoke with the PA on Thursday. The PA was fervent that the orthopedic surgeon would prefer my dad be on Ambien, despite my warnings about his prior experience with the drug. The PA told me she would ask the orthopedic surgeon and call me back.
The PA never called me back. Dad slept about 3 hours a a time last night (and therefore I did too).
The orthopedic surgeon's staff frankly does not like me - undoubtedly because I am a vocal and strong advocate for my dad.
Last night and this morning, my dad was weeping with pain. And dad kept asking me to talk to Dr. Easley about the degree of pain. Neither my mom nor my dad thought that Dr. Easley would want dad to be in pain.
And so my mom followed up where I could not (I am exhausted from lack of sleep and mom has slept!) My mom called Dr. Easley's office and just plainly said that there would be no way Dr. Easley would want his patient to be in pain and tears.
Finally, the staff (that understandably tries to protect the surgeons from nuisances like the patient's family) asked Dr. Easley about pain medication so that dad could sleep through the night. Of course Dr. Easley okayed the prescription. And those were my dad's precise words. Then dad said thank Dr. Easley for me.
Once again, you cannot underestimate the importance of a patient trusting his or her physician. It was dad's unconditional and well placed trust in his orthopedic surgeon that got us all through the last couple of days.
I am off to Durham to pick up the prescription so that my dad can get more than 4 hours of sleep and he can start healing!
When I first entered the Duke Medical Clinic where I was treated by orthopedic surgeon Dr. Mark E. Easley, there was a sign in his office that stated "We do not want you to be in pain" and "Ask us how to help manage your pain." The year was 2002.
As the years have passed, attitudes about pain management at Duke Medical have dramatically changed. In fact, now secretaries, para-professionals and perhaps even physicians seem suspicious of patient's complaints of pain after a pre-determined, cookie-cutter length of time.
My dad is 76 years old and underwent an apparently complicated orthopedic surgery that required the placement of an external fixator on his left foot and lower leg. For the last two weeks, the orthopedic surgeons have tightened the screws with basic wrenches. They are "tweaking" the placement of the large bones.
My dad is trying to be compliant (a pleasant surprise for the surgeon - I am sure). Dad does exercises in chairs and actually (and even 24 days out from the surgery looks forward to physical therapy at the Duke Fitness Center.
But there is no way around the fact that dad is in pain. Dad's pain manifests itself with thrashing of his injured limb. And, as much as I try to keep dad's opposing leg covered, the thrashing is literally tearing up dad's right leg. He has a rather large sore that seems to be infected - caused in large part by the thrashing of an external fixator."
The orthopedic surgeon's office is insistent that my elderly dad must remain on pain medications that require re-dosing every 4-6 hours. That translates into my elderly dad not getting a fill not sleep (and me, as the caregiver also not getting a full night sleep).
The orthopedic paraprofessional suggested that my dad take Ambien. I reminded her that he does tend to sleep walk with other sleeping pills.
Last Fall, dad was scheduled for surgery at Duke. He "woke up" in the middle of the night and thought he was going to miss the surgery time. He could not find his car keys (there is a God) and so my 76 year old dad with a terrible foot infection started the walk to Duke University Hospital. That's a 40 minute drive. A town police officer woke me up with a bang at the front door. Now I know what parents of teenage children fear most. Dad was in a squad car explaining to officers and neighbors that he was having surgery later that day. True enough. He is not senile --- just sleep walking.
Anyway, there are many options for pain relief beyond the Medicare approved hydrcodones. There are patches, "additives" such as neurontin or antihistamine. There are also longer acting pain medications - 12 or 24 hours.
For the last two nights, dad has not had the longer acting pain killer and he wakes up in startled pain like clockwork - every four hours. I am beginning to feel like a fireman or a new parent. I am exhausted.
I yearn for the days when medical professionals worked with their patients. If my 76 year old dad is not sleeping well then how the heck can he be healing? It seems now that medical professionals are suspicious of patient's request for pain medications.
The patient is over sensitive because of pain and lack of sleep. Consequences:
(1) The patient begins to distrust that the medical professional even cares about the patient.
(2) Or worse, the sensitized patient may feel as though the physician's office does not believe the patient's complaints of pain.
I am not sure how or whether I will be able to get proper pain management for my elderly dad. But you can darn sure that I continue to try.
Dad is rapidly becoming physically and emotionally weak with 2 bad nights of sleep.
And this situation reminds me that under Obama Care, my dad would have never undergone the complicated orthopedic surgery. He is a cancer patient and elderly. Obama's federal medical board would consider my dad to be a waste of money.
The orthopedic surgeon, Dr. Mark E. Easley, has requested that I modify my blog as it relates to two orthopedic residents that cared for my dad while he was inpatient at Duke University Hopsital. Dr. Easley assures me that all of the residents in his program are "competent" doctors. To the extent that my primary concern is the failure of Duke University Hospital to institute regulations that require DUH hospitalists to contact, communicate, cooperate and, if necessary, coordinate with patients' current treating Duke Clinic physicians and surgeons, hammering on individual, inexperienced doctors is a distraction.
I agree that the blogs referring to those gentleman must be changed. But I am not getting sleep either as I have to be "on guard" to help dad during the night with his pain issues. I am exhausted and cannot wait until I can take an Ambien and get an effective sleep. Until then, dad (and not my sleep) is the priority.
I hear him on the "daddy monitor" -- gotta scoot. I am so proud of my dad. He is tough.
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