:::sigh::: Dear Providence,

I received your letter informing me that you found the "care delivered by Dr. Ird appropriate".

Well that's special.

If tossing five different BP meds at me without checking to see how I was feeling in between is 'appropriate', then I'm gonna go with,  the standard of care you offer needs some work, guys.

But while I have your attention, oh team of investigators, ponder this:

When I originally contacted Providence, I didn't address anything that had happened at the clinical level or request any sort of investigation.

The investigation was initiated by the person I'd contacted at the hospital level.

So *I* didn't request any sort of evaluation of my doctor at that time.

No, I contacted Providence because of the utterly appalling experience/treatment that happened in the emergency department of the hospital.

I'm still stunned at how amazingly bad their 'care' is.
I wonder how many people have had their conditions made worse simply by going there? How many people have just died due to negligence?

My concerns ranged from the complete lack of safety protocols in the waiting room (masks dangling from the ears of the security guys while they looked at a phone and shared videos with their heads inches apart, laughing and chatting with a third person, this time a girl person who showed up and wasn't wearing HER mask, either) to the ridiculous attitude from the doctor? providing care for the people who'd gone there for help.

I was concerned about the person who was in need of immediate assistance, unconscious in her wheelchair, bent over at the waist, head lower than her knees. She was ignored and ignored and ignored by various staff until I finally pointed her out to one of the triage nurses.

It was an utterly horrendous experience, made worse by the ugly disregard for the humans who needed assistance in the middle of the night from almost everyone there.

I did not, at any time, ask to have my doctor's handling of my care at the clinic level investigated.

In fact, I said in the beginning that although I was disappointed that she had not listened to me regarding the possible effects of the heartburn medications on my blood pressure and that it took much too long for her to call me back with instructions on stopping the lethal BP meds, the real issue at the clinic level was how my care was handled while Dr. Ird was on vacation.

I was dismissed by the receptionist who answered the phone, and when I stood up for myself, grudgingly transferred to a nurse who, when told my blood pressure was 248/171 told me I was 'taking readings too often'.

I was patronized and condescended to and my LIFE WAS IN DANGER.

She should have immediately had me seek treatment, instead she just casually acted like nothing was wrong except that I was checking my blood pressure more than she wanted me to.

In the case of the receptionist, I'd call it a training issue. Possible burnout, I'm sure her job is overwhelming during the best of times. But her tone was unmistakable.

In the case of the nurse, I'd call it gross incompetence and a serious breach of Providence's contract to provide care. My life was endangered and she wanted to quibble over how often I was checking my blood pressure.

So thanks for the letter about my doctor, but that wasn't the whole issue.
I'd like to know that the person answering the phone is going to work on that patronizing tone in her voice and just, you know, do her job.

Further, I'd like to know why someone who's a trained nurse just brushed off the dangerously high blood pressure as too-frequent-measuring.

Until you've done that, you haven't actually investigated.

Doctor Doctor

 Well.

I got the medical equivalent of 'I'm sorry you feel that way'.

She was 'sorry you didn't feel heard'.

To which I answered, "No, I didn't 'feel' that way, that was exactly what happened. I wasn't listened to here at the clinic or in the ER. No one gave a shit about what was going on, no one called me to see how I was later, no one seemed to understand the meaning of a medical emergency. Those aren't feelings, those are facts."

She wanted to know why I think my BP is down, why I haven't had so many migraines, why I'm feeling so much better.

Um, really?

So I told her I'm pretty sure the heartburn medication I was taking wasn't good for me. I said that was the first example of not being listened to.

I told her a little about the hospital visits and told her about my efforts to get someone to listen to me at the clinic while she was on vacation. I think she believes that since she wasn't there it had very little to do with her, but that's not true. She was the very first one to refuse to listen to me or consider that the heartburn medication was causing me problems.

I have a reputation for being good with words, and if you only know me from here, it's understandable for you to think that way. I write, I edit, I change things, I write and edit some more. I mess with it until it says exactly what I wanted to say.

There are times I come back a week later and fix something.

Occasionally an error gets past me and I have to fix that, too.

So I have control over writing, and can take as long as I want to.
Not the same in a personal conversation.
Dammit.


When I'm in the middle of a situation, it's hard for me to think quickly enough to have answers ready, sadly. Most people will say the same, when they look back at an event they say, "Oh I should have said _____." Or, "Why didn't I tell her ______?"

I managed to say a little, but not enough.
I just didn't have it in me today.

It didn't help that the early morning hours (3 to 6-ish) were filled with a huge thunderstorm, complete with flash after flash of lightning. I  couldn't stay asleep longer than a few minutes, and when Eric got up to go to the bathroom, I woke up again. 
So like 8 times in a 2 hour period. After not managing to fall asleep until close to midnight.

Ugh.

A large part of the problem with Providence is what they expect of the people who work there, from custodial staff all the way to doctors. They expect them to do more than is reasonable and instead of improving the situation by adding more staff they're nasty to people who can't complete all the work that's expected of them and they get discouraged and they quit.

Not only did I lose Dr. Dirtball, but more than one friend/acquaintance couldn't take the BS anymore and left. I've known at least five through my work (parents of my kids) who had a whole lot to say about Providence and the working conditions.

I could have said a lot more, but I'm okay with how things ended up.

My prescription is filled, I have an appointment with a different doctor in a few weeks and I'll see if I like her.

Well. This is surprising.

I'm not going to have to pay for any of the hospital costs associated with the craziness that happened to me in July.

I could be a little more surprised, but not much.

Insult to Injury

I wish I had something other than a cliche for the title.

If I thought about it a little, I might be able to come up with something, but I'm not that ambitious right now.
::sigh:::

So Providence managed to find my paperwork and properly process billing for the Mongolian clusterfuck (x2) in the ER.

Now, instead of $6500, I 'only' owe $850.00.
FOR EACH VISIT.

I also haven't heard what happened with the investigation. What I wanted to have happen is that my letters/words would be printed out and given to everyone involved in not bothering to take care of business. I don't know if that happened, but I'm going to ask.

I sent an email this morning.
It went to both the hospital investigator person and the clinic investigator person.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I had negligent and plain incompetent care from my clinic and from the ER at Providence main campus in JULY.

It's now mid-September.

Doesn't matter, though, I'm still stuck with Providence if I want my insurance to cover.

After asking several friends for their recommendations, I have made an appointment at a different Providence clinic to consult a different provider and see if she might be able to understand my needs and provide competent care, but they're unable to see me until mid-October.

Since I have an ongoing condition and a prescription that expires in a little over a week, I have no choice but to go back to the same clinic that made the string of errors and patronized and dismissed me when I called for help.

I am not happy about this.
It makes me feel sick and scared.
I don't even want to walk back through those doors.

Neither of those hospital visits would have happened if I hadn't been prescribed (different) medication(s) one after the other after the other after the other that I didn't need in the first place.

My life was endangered because of that and because no one I spoke to on the phone at the clinic seemed to understand that 220/178 BP was a life-threatening emergency.

My doctor, with whom I had developed some degree of trust, seems to be gaslighting me.

At least that's the impression I have received from the bits of correspondence on MyChart.

Let's admit I wouldn't have a gigantic hospital bill that happened SOLELY because of negligence on the part of my "healthcare" provider.

And that no one ever called to find out how I was doing after the craziness. When I had to take our dog to the vet for some routine care, they called me three times in the next week to make sure she was doing okay post-treatment.

Let's not forget that I've heard absolutely NOTHING about the resolution of any of these issues.

I'm not inclined to sit quietly and wait any longer.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I  got a response from the person in charge of investigating the hospital side of things. "Reviews have been completed at the hospital and follow up done with nursing, security, MD"  Her email also contained this line, "The billing for your hospital stay is on hold as well while we investigate. "

So I responded.
"Right now I'm holding an 'explanation of benefits' that came in the mail a couple days ago.
It tells me my responsibility for the craziness and incompetence and callous disregard for my health is almost $850.00. There is no mention of this bill being 'on hold', either."

She responded quickly. "I am going to look at the billing today and see what I can do. Be right back to you ASAP! So sorry for your worries Susan, this is just added on top of everything else going on right now."

So we'll see.
With the things that have happened, I am not expecting miracles.

It would be nice to have one, but I'm not expecting it.

I'm definitely going to ask if my words were passed on, though.
It would be nice to hear they had.

Just when you thought it was over...

You're not going to believe this.
Or maybe you will.I admit to being a little shocked.
Well, not really.
Since the whole thing has been crazy from start to now.

But in the mail yesterday was a bill from Providence for... wait for it...
SIXTY FIVE HUNDRED DOLLARS.Yes, that's right.

I don't have medical insurance according to their records.

Since I'm sure their record keeping is on par with everything else they do, I guess all I can do is roll my eyes.

So I sent an email to the HR person at my job last night after the bill showed up.

"Hey Lisa,
Could you please verify that my coverage under COBRA began on July 1st this year?"

I waited until 11 this morning to hear back from her, she's usually very prompt. When she didn't call, I called her instead.

She told me she'd called Providence first thing this morning. She said they'd told her they 'have no record' of payment for me from our organization, although everyone else's has been accepted.

"Huh," she said. "It's odd that of all the paperwork I've sent in, yours didn't go through."

"Oh it's not odd at all," I told her. "Considering how they're running stuff at Providence, it's not odd at all."

Then I filled her in a little on what's been going on.

There were several, "Oh my gods," and a couple gasps.

She told me to stop worrying about the insurance issue, that she'd take care of it and let me know when it was handled.

So sometime in 2024, I'm sure the bill will get settled.

I've also asked my local friends for a doctor they'd recommend if they're stuck at Providence.

I heard from a former co-worker and she highly recommends her doctor.
Her doctor is also a girl-type person (super important to me) and very good at listening.

She told me that Dr M was the first medical person who'd ever actually listened to her and worked to give her a proper diagnosis. I won't tell her secrets here, they're really not mine to tell, but I can tell you that she's in better health right now than she has ever been thanks to a doctor who listened and conducted the appropriate tests instead of evaluating her by her appearance.

What a novel idea.

I know that the not-very-large amount of trust I had placed in my doctor is just gone. 

I don't want to see her again except to read her a letter I'm working on.
I want her to know exactly what happened to me both at the clinic and hospital level. 

And while she doesn't bear 100% of the responsibility for all of it, she didn't call me back to let me know how to get off the medication that was fucking killing me for THREE GODDAMN DAYS.

And yes, I know she has a lot going on, that her employer expects a great deal from her... but she deals in life and death situations and she didn't give a shit what I needed or how I was feeling.

I don't need to be her number one priority, but I do expect respect.
And I didn't get that.
Over and over and over I didn't get that respect I deserve.
 
I now have zero confidence in her ability or wish to help me if I ever have a serious issue again.

So I'm calling for an appointment with my friend's provider as soon as Providence gets the goddamn insurance mess straightened out. It's still a Providence facility, (can't escape that) but it's about a half hour drive. If I get a doctor who actually gives a shit, it's worth it.

I can at least meet her and see what I think, right?

Meanwhile, SIXTY FIVE HUNDRED DOLLARS.

Bullshit. Just bullshit.

OMG they're still trying to kill me!

Things continue to be in normal range with my BP.

Never claimed to be a doctor, but I do have a bit of awareness with my own body and I'm still kicking myself in the ass for taking the medication(s) in the first place. And in the second, third, fourth...

Haha, speaking of medications, which I keep typoing as medicatoins, don't ask me why, I know how to spell, dammit, the pharmacy messaged me yesterday to let me know the second BP medication, Lisinipril,  that had been prescribed (back in April? I think?) has been refilled and it's time for me to come pick it up.

Yeah, that's not happening.

Then, the Metoprolol, which almost fucking killed me... my DOCTOR'S OFFICE messaged me this morning to ask which dosage to send to pharmacy to be refilled!

You know, the stuff that I quit taking 'cause it was causing my BP to go higher than most of the satellites in low earth orbit?

The stuff that landed me in the ER not once but twice in the same week? Yeah, that stuff.

MY DOCTOR'S OFFICE. WANTS. TO. KNOW. WHAT. DOSAGE. TO. GIVE ME.

Yep, I replied. And I refrained from using profanity, but it was tempting to open up a big jar of fucks and sprinkle them liberally throughout.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Here's my reply:

Please update my records to reflect that Metoprolol sent my BP into the stratosphere, landed me in the emergency room not once but TWICE in a span of five days AND inspired some of the most condescending and patronizing behavior I've ever seen from medical personnel, some of them right there in your office.

Why was this not already updated?
Holy cow.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
What the hell are they doing there?
They're sure not providing medical care.

Meanwhile, tomorrow is the day that the hotshot investigators are supposed to be concluding their investigation into what happened to me in the ER and at the local clinic.

I'm about half-tempted to order a t shirt to wear next time I go in.

On the good side, I have just taken a blueberry cobbler out of the oven (it's 72 here today, perfect for baking, don't you agree?) and I'm going to go cut some and relax awhile before time to make dinner.

And how is your day going so far?

Just take the meds, Jabba.

Every time I meet a medical provider for the first time, I'd have to be an idiot to miss the way they size me up.

Haha, no pun intended, but yeah.

I'm not a small person.

I've lost almost exactly 50 lbs in the past year and I'm not done, but unless you know me well, you wouldn't know that.

So their judgment is about 90% based on how I look.
The other 10% is the fact that I'm 'just a babysitter'.
I don't have a real job, ya know. I just take care of kids.

They look at me and drop about 20 points from my IQ before we ever exchange more than pleasantries. I can see it in the way they look at me.

It only goes downhill from there, as I'm not there for them to get to know and I sure as hell don't want to become friends with them, either.
And no, it's not me projecting.

I might be more open to believing that if:
A; it didn't happen every damn time and
B; if those 'professionals' didn't find an opportunity during our conversation to tell me how fat I am and tsk tsk disapprovingly. 

Oh, they don't say, "You're a great, fat hog."
No, they use words like risk factors and high BMI.
Those words are reinforced with disapproving tones and serious stares over the tops of their eyeglasses.

I'm told, sometimes forcefully what *I* need to do to fit into their little box. That pathological need to classify me and FIX me pisses me off more than just a little.

When Dr. Ird (I-replaced-dirtball) lectured me back in March about my BP, she was very intense. Wanted me to get an idea of how important it was to take medication.

"Your numbers just keep going up!" she said, leaning toward me.
"There are many things that can happen to people who have high blood pressure. You could have a stroke! You could have a heart attack! That pressure is making your veins just pound and pound!!"

(an aside here... my BP was like 140s/100's... not good. But compared to what happened when I started the BP medication-go-round?
It was amazing.)

She punctuated her lecture by smacking the back of her right fist into her left palm repeatedly.
She tossed in some threats about how if I had a stroke I wouldn't be able to draw anymore or do the things I usually do.
So against my gut feeling, (she completely dismissed my concerns about the heartburn medications and possible effects from them) I took the damn BP medication(s).
And didn't that go well!?

First, no one called me. NO ONE gave a shit. No one called to see how the medication was working. No one asked after each change how I was doing. I am able to take responsibility to keep an eye on things myself, and it's a good thing I do, but really. Not one call?

The effects caused by every single one of the doctor-prescribed drugs were horrendous.

Don't call them 'side' effects, as they. Fucking. Aren't.
They are effects, life-threatening and goddamn expensive.
(I thank my friend Natalie for that way of looking at it, I hadn't really considered it before.)

And when the first poison didn't work (bumping my BP up into the 220/130!!! range could be called unsuccessful, amiright?)  they said,"Why, let's try another!"

We did.

And another and another. 
It kept getting worse.
And made me so ill.
My god.

My doctor, who didn't get back to me about how to discontinue the first medication until DAYS after I asked for help, was on vacation during that crucial week.

And because I listened to her about the medications in the first place, I got horribly ill in the middle of the night and sincerely believed my life was in imminent danger, because I had NO OTHER OPTIONS I ended up in the ER two times in five days where they failed to do anything for me other than help with a migraine brought on by one of the poisons THEY gave me in the first place!

I was demeaned, dehumanized, degraded.
Talked down to.
Treated like a hypochondriac.

I'm actually embarrassed that I listened to any of the bullshit about getting on BP meds and didn't just take myself off the goddamn heartburn medication in the first place just to see.
(Medically Non-compliant, that's me.) 

When I called the clinic after the first disastrous exposed-to-a-billion-pathogens-by-clueless-hospital-personnel-AND-patronized-to-boot visit to the ER, I was effectively dismissed by the goddamn receptionist, too.

When I said, "Hey, my blood pressure is way up and I ended up in the ER and could I please come in and talk to someone," her response was to dismiss me.
She told me my numbers were, "Stable when you left the ER."
Her tone was unmistakable.

I was actually breathless/speechless for a moment.

She added, "And there's a discrepancy between your readings and theirs.

I covered that in that post, I don't want to write it up again.
She's just another asshole in an ever-growing line of them.

Yeah, that was fun. I spent MORE money to go in and talk to a nurse practitioner and be told I needed to schedule this test and that one and come in and have blood drawn (again). To be fair, she did listen to me.

When I called the clinic on Tuesday to verify, they told me their lab was closed. Which is a lie. It's open to appointment, I was told to come in.

But I had to wait on hold again for 10 minutes to find that out.
Have we talked about being on hold there? It's shrill, obnoxious, loud, OBNOXIOUS.

Several cycles of how to quit smoking and lose weight and get good sleep interspersed with a giant booming voice thanking me for my patience and assuring me they'll be right with me. With a clashing and discordant attempt at music. If you're already feeling like crap, or you have a headache, that stuff doesn't make things better.

What they really need is a 'press 8 if you'd like to be on hold without the noise' option. Just that would be amazing.

Streamlined isn't a word I'd use to describe how they do things.

I also would not use the words compassionate, caring, or concerned.

The feeling I've gotten in about 95% of my dealings with the clinic/hospital system I am *required* to use is that single patients do not matter on an individual basis.

We're just numbers, and if we die, well there are plenty more.
Before all this happened, I can't say I had a great deal of trust invested in Dr. Ird, but I didn't dislike her. I don't dislike her now, either.
But that tiny little bit of trust I had?
I don't have it now.

She's laboring under some pretty ridiculous standards.

I know what is expected from the doctors where she works.

I know I mentioned that I'd followed Dr. Dirtball there.
I'd been seeing her for 16 years and considering who I am and what I think of the practice of medicine in general, I'd developed some amount of trust.

When she informed me that she was leaving the practice, I asked her why.

She sighed.
Wearily sank down into a chair across from me.
Leaned forward, elbows on knees.

"Do you want facts or the sanitized version?"

I raised an eyebrow. "You've known me 16 years and you have to ask?"

I don't remember her her exact words.
I do remember the defeated tone in which she said them.

They wanted her to sell, sell, sell.
Sell vaccines.
Sell tests.
Sell more tests.

She was supposed to make everyone get a flu shot.
Be tested for hepatitis if they were born before 1963.
Catch up on booster shots for this and that.

The practice sees a large number of geriatric patients.
Medicare pays for that.

And for them, there's the added bonus that people of that age group are more likely to do the medical equivalent of 'Yes, Dear' when the doctor tells them they need something.

She was never able to measure up to their production benchmarks, either. See X amount of patients per day.

She usually worked through her lunch hour, either seeing patients or catching up on paperwork. She came in on weekends and on her days off so that she could do more administrative tasks.

She was worn out. Tired. Discouraged.

"This place is not about patient care," she told me.  "They are only concerned with how much they can bill. If you have good insurance, they will order more tests than you need to add to their magic totals."

Not what she'd thought she was signing up for when she closed her solo practice.

She confided that when she'd practiced alone, she spent so much time on the telephone with insurance companies arguing about coverage that she was constantly behind and harried.  Her stress level was making her ill.
She said wryly, "I thought coming here would make things better for me. It hasn't."

She commented on the revolving door of the practice, too.
So many doctors come and go, and can't take the pressures being placed on them from above. They tell them why they're leaving, but nothing changes.

She had thought that being able to hand off the administrative tasks and day-to-day minutiae of private practice would give her time for the actual practice of medicine. To do patient CARE.

"Not this." she finished, gesturing around her.

Said it again, defeatedly, "Not... this."

A few days later, she was gone. I haven't seen her since.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

So here's where I am now.
I've been off the heartburn stuff for three weeks now.
My system seems to be balancing a little better. I still have a bit o' the burn, but I have generic tums and generic Pepcid for the worst of it. It's keeping things under control.

I decided to taper off the latest BP medication, the one the veterinarian-masquerading-as-a-human-doctor in the ER prescribed for me.

When I took one, within two hours I was nothing but clammy, out of breath and weak for about 14 hours. It made me very ill, just like all the other shit they've tossed my way.

I did not call the clinic to ask for help in stopping this medication. I've already seen how 'helpful' they are. And their demonstration of how much they 'care' has been quite clear.
Fuck that.

So I did the same get-off-the-med routine my doctor left me on my voice mail four days after I started the process with the first medication. I'm on a skip day today.

My BP has been 120-123 over 79-82 for three days in a row.

Gee, it's almost like those heartburn drugs that I'm no longer taking had something to do with the high blood pressure.

Why didn't I think of that?

Oh yeah. Guess I did.

It's hot. I'm still alive.

So the weather has heated up.
Does that every year around this time.

People have so much to say about how it's 'weird', but we're in summer and it's, well, hot.

Always cracks me up to hear people exclaim over the heat, as if it's a new thing. Six months from now they'll be doing the same over the cold/snow/ice. As if it never happened before.

So I've been staying indoors.

Not that I feel like going anywhere.
Feeling a little weak and wimpy.

No appetite. Which is probably fine, I could live for six months on what my body has stored. Haha, long enough to complain about the ice and snow and wind we get here.

Wednesday I have some tests.
Don't ask me what they are, as I can't remember right now.
But I'll be asking a bunch of questions when results come in.

Have to call the doc office tomorrow in fact, since I'm not messing around with waiting for them to call me about the other things that are supposed to get scheduled.

Made an appointment with my dentist, too.
One of my teeth is bugging me. No pain, but I think I either have a cavity or some other problem in one of my wisdom teeth. Yippee. Can't be in one of the teeth that's easy to get to. Oh hell no.

Blech.

Also, haven't said anything to my parents about what's been going on with me, as there is seriously not a single thing they can do other than worry over me. I figure they have enough to think about.

Once I have some answers, it's possible that I might share some information with them. Not sure yet. I guess it depends on what they tell me.

And how are YOU doing?

Providence would like my feedback!

The second 'how are we doing?' survey from Providence Hospitals, Portland, Oregon has landed in my email box.

They opened with:
Dear Susan ,

Our commitment to you, and everyone we serve at Providence, is to ensure patients and families experience quality health care and unforgettable compassion. Our Promise is to "Know you, care for you and ease your way" as we partner in your health.

I am almost never speechless, and I'm sure I'll regain my ability to write a factual email that is still scathing in tone so I can answer that.

What a ridiculous and overflowing crock of shit!

But wait.
Maybe I'm being unfair.

Perhaps their use of quotes around part of their message is used the same way I use them when I share my feelings about politics and our "representatives".

Hm.
No, I think they think I'm gonna believe that crap about 'care'.

HAHAHAHA

I suppose that sets the tone, though. From the top... "Man, people are STUPID! Let's just tell them this and that and how much we CARE, they'll believe it! Watch!"

And the condescension filters down into every aspect of hospital operation.
I think something a little more honest would be good.

Maybe, 'At Providence, we worship money.

We pretend to be religious (I'm sure you saw the crucifixes hanging almost everywhere you looked... even above the blood spatters on the wall in the treatment room you were last in and we refer to the 'original sisters of Providence quite often) but make no mistake, we are only interested in one thing.

The religious angle is there so we can get government money for all the people we 'care' for. And calling yourself non-profit doesn't mean you can't make money. A whole lot of money.'


Religion?
Well...  there were a couple things during my 2nd visit that caused a JESUS H CHRIST to burst forth, is that relevant?


Unforgettable compassion?
There were several aspects of my 'care' that were unforgettable, but I saw no display of compassion from anyone involved in my care.

I did see one instance of compassion, though.

There was an elderly homeless man sitting all alone in the corner of the waiting room, covered in white hospital blankets, surrounded by garbage bags of his possessions. He was holding a phone in his right hand and sleeping soundly, nasal cannula in place. His phone rang a few times, he slept right through it.

The phone at the security desk rang, the guy sitting there (he was wearing a mask, unlike the guys from the first visit!!) answered. Spoke briefly, hung up the phone, then went to the man, still sleeping.

He placed a hand on the man's shoulder.
"Mr. Smith," he said. "Mr. Smith."

The gentleman roused a little.

"Mr. Smith, I just had a phone call from Helping House." (not the real name of the place, I just can't remember what it was) "They said they have been trying to call you. They are on their way to pick you up. You rest now, and when they arrive, I will let you know."

He patted the guy on the shoulder again, looking him in the eye and treating him with the utmost respect. He left his hand on the man's shoulder longer than necessary, squeezed his shoulder gently before removing his hand.
It was nice to see.

I went to the hospital because I woke up at 4:00 short of breath, my heart was fluttery, my left arm was aching in time with my heartbeat, I was dizzy, sweaty, shaky and sick. Oh, and my blood pressure was up into the holygoddamnfuckbatman range. I was, bluntly, scared to death.

I wish I could tell you my treatment was compassionate, caring, felt any kind of partner-y ... wait.

What treatment?

Are we talking about how the doctor treated me?
She walked into the room, immediately remembering me from 5 nights prior.
I saw her face change.
Well, her eyes, above the mask.

She didn't have time to change her shirt, but I'm sure she would have chosen the I see hypochondriacs shirt probably hanging in the front of her closet.

She treated me like an idiot.
She talked down to me, using a disapproving tone to tell me that stopping the heartburn medication was 'a bad idea' even though my doctor said it would be fine if I could manage it. She 'found it hard to believe' that every one of those blood pressure medications had those side effects.

Those were her actual words. "I find it hard to believe."

Worse, she looked to my husband for corroboration. She wanted him to side with her against me. She tried twice to draw him into the conversation, he looked away to avoid eye contact or interaction with her.

She dismissed the pain going down my left arm and radiating up into my left ear.
"Oh you probably slept on it wrong."

She did manipulate the shoulder, when she said, "What about this?" expectantly and I answered, "No," she again looked skeptical. Yanked my arm another direction with the same results. Did it again. same answer.
She actually rolled her eyes at one point.

She did some serious arm-pulling, I'm sure she was pulling my arm 'cause she believed *I* was pulling her leg, but there were no answers.

She did give me something for the screaming headache I'd gotten from the medication. I am grateful for that.

I didn't explode with anger. I was too weak, wobbly, scared and upset.
I wasn't sure I could remain coherent.
And is there any point in engaging with someone like that?
Someone who clearly doesn't give a shit?

I knew I could talk all day long and she'd get that glazed look on her face and not hear a single word. I was too weak to even bother.

Here's the thing.
I have been living in this body for about 60 years.
I fucking know when something is affecting me.
I pay very careful attention to how I'm feeling and what's changing day to day with the medications.

This isn't a joke, it's serious shit and I'm TAKING it seriously.

I can't imagine anyone goes to the ER for fun.
Definitely not that one.
I had NO CHOICE, that's where my insurance dictates I must visit.

It's not an especially clean place, either.

I noticed, especially when every other hospital I've ever visited has been immaculate.

And going twice in 5 nights for excitement!?

Dear god.
I'm one of those sorry assholes who's not only lost their job but lost their insurance benefits because of the plague. I had *just* sent my stuff in to elect to continue the coverage at my expense when all this shit started happening.

So not only am I paying an exorbitant amount for coverage, I'm sure I'll get a whopping-ass bill for the two ER visits in which they did absolutely NOTHING TO HELP ME, were condescending, patronizing, and dismissive.

They displayed all the sensitivity of an alligator.

I don't expect to develop lasting friendships with ER personnel. I won't be inviting them to bbq parties or send them presents on their birthdays. I'd feel awkward if any of them invited me, too.

But simple respect and being seen and heard would be nice.

I don't want to die from this crap.
Right now the plan is for a meteor to take both of us out when we're about 80 or so.

So, Providence, that 'commitment' you tossed into your mission statement? I don't believe a single word. Did anyone 'know me, care for me, or ease my way'?
That's a big, fat no.

Answers

Well.

I was heard today.

Yesterday afternoon I called my doctor's office.
Even though she's out of town.
Because I am scared, dammit. This is a lot going on suddenly, and I don't like any of it.

When something that's supposed to HELP your BP actually makes it worse...a LOT worse, it's no fun. When they swing FIVE TIMES at the BP and completely miss, it's not fun, either. My readings have been horrendously high, the medications have made me sicker than hell, and no one is goddamn helping me.

First I got some twat on the line who wanted to tell me that my BP reading when I left the ER was 'stable'. And when I asked her if those numbers were an acceptable range, and told her my current reading, she said there was a discrepancy between my home BP cuff and the hospital reading.

Well no shit, Sherlock. That's why I brought my cuff in to check against the one in the office!!

I told her, "Yes, there sure is. But six or seven points difference isn't an issue in this case and a stable HIGH BLOOD PRESSURE is still high blood pressure. Are you not getting this?"

But I got pissed off, too. I told her that I'm completely sick of being patronized and condescended to and that I want a referral to a specialist because, "As of now, I am goddamn sick of being dismissed."
 
 So she said, "Hang on, I will have you talk to Diane."
(Diane is one of the nurses.)

"Nope. I talked to her twice last week. She doesn't give a shit. Is there anyone working there who cares about the patients?"

I'm not nice when I'm angry.
And I'm not just angry, I'm sick and scared.
So be nice when you're on the other end of the line, because you will be hearing some shit if you're not.

So when they do a referral, they do this test and that test so you're handed off to the next doctor with all your bloodwork and other stuff in a neat little package.

The person they had me talk to instead of Diane asked me if I'd come in today for those tests.

"Can you guarantee that it's not still another condescending asshole?" I asked her.
There were a couple moments of silence on the line. Then she said, "She's really good. And she's very nice and a good listener."

I told her, "Look. I realize that you're not the problem here, and that you're the one stuck with a phone call from an angry person. But consider... I wouldn't BE an angry person if I'd been treated with respect by everyone else. So I'm sorry you had to be the one to hear this, but I can't say I'm sorry for saying it."

I had several different tests today.

Also have some other things scheduled for Wednesday.

And there's one test they can't do there that I'll have to drive down to mid-Portland for. That's fine.

Today, though, someone finally listened. To everything I had to say. I went over my entire list. I told her about all the side effects I've experienced and about being dismissed and ignored and that I am no longer sitting and waiting for assistance, here's what I want, and yes, I want it now.

So here we go, I guess.
::sigh:::

When I got home and checked email, I found an email address to send my commentary to. I did that immediately, since it was all written up.  I'm not done, though. It's going to the state regulatory board as soon as I have the energy to do so.

I need to get a better saddle if I plan to take up tilting at windmills as my new career.

Medical 'Care'

This is what I wrote up for my review of Providence's 'care'.
Exciting epilogue... I had chest pain and some pretty interesting stuff going on AGAIN at 3:30 this morning so guess where I went AGAIN?

I did learn that if you present in the ER with chest pain they bump you to the head of the line, though. Expensive fucking lesson, I'm sure.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Some waiting area staff were not good at observing safety protocols. Security guys sitting in the corner at their station, masks dangling from one ear, heads two feet apart as they looked at stuff on a phone, laughing and chatting.

A woman came and talked with them awhile, she also did not have a mask on.  All three of them had a lengthy conversation, punctuated with laughter and hearty voices. All unmasked.

Since they're on the front lines, as they say, it seems to me that the possibility of them spreading Covid-19 even though they were not displaying symptoms, is bigger than average.

Most of the people in the waiting room were there because they were ill in the first place, so I can't understand the logic of sitting unmasked and exposing the general public to still more pathogens.

Upon my arrival I saw a person sitting to the right in the broad entry walkway  a little to the side. She was in a wheelchair, bent over at the waist, completely passed out, head lower than her knees. A white garbage bag full of her possessions and a purse were on the floor in front of her chair.

A puddle of unknown substance was slowly spreading under her chair.
I observed several Providence employees walking past the puddle, adjusting their route to avoid stepping in it.

So yes, they saw it.  But chose not to see HER.

No one stopped to check on the person who was not in a safe position, unconscious. Providence personnel came and went from the triage rooms, passed within a foot of her MULTIPLE times and didn't see her.

I finally pointed her out to a woman who was doing triage. She looked carefully at the unconscious person, said, "Well, that can't be comfortable,"

She got reinforcements who gloved up and went to move the patient. They tried to get her to sit up, but she was in very poor condition and unresponsive. They wheeled her away. The puddle of liquid was left on the floor. No one came to clean it up, although I noticed hospital staff still walked around rather than through it.

Another person was in one corner of the waiting area vomiting loudly and constantly for approximately 45 minutes.

Who knows what pathogens the unmasked Providence personnel (and already compromised patients forced to wait in the same area) were exposed to? I do understand the purpose of triage and that many patients were waiting, but it seems that one of the factors involved in triage is assessing the risk to others in the vicinity of the ill person and that someone who is projectile vomiting is not only in dire straits, but the people around them are at risk of getting whatever contagions they're spewing into the air.


I went to the ER because we have been working to get my blood pressure under control and failing.

We've tried several different medications and I've had some interesting side effects. I pay close attention to how I am feeling, take daily BP measurements and monitor myself.

The medication I had been taking was making me very ill, was causing horrendous spikes in my readings and instead of lowering my readings, had raised my blood pressure to dangerous levels, so I was in the process of weaning off the medication. It's dangerous to completely stop the medication all at once, so I was following the protocol set forth by my doctor.

As I was getting ready to go to bed on Thursday night, I suddenly became very raspy-voiced as my throat started to feel closed. My breathing was working okay, but a deep breath caused me to feel something like sand swirling in my chest and my throat and made me cough.

I began being dizzy. I became weak-kneed and sweaty. The cough and sandy feeling worsened.

Those are not good symptoms, and coupled with the discontinuation of the medicine, made me decide I should seek medical attention.

I'm not sure I could say I actually received medical attention, but that was the goal. I feel confident that during the entire time I was there, no one actually listened to me.

They sort of listened to my *words* but clearly attached their own meaning to them.

I felt dismissed and patronized.

I do understand that the people who work in the conditions of an emergency department see a very broad picture of society and various amounts of lunacy in an unpredictable and sometimes shocking manner. And that ER medicine is not a clinical atmosphere. Had I not been dealing with the blood pressure issues and medication-go-round, I wouldn't have even considered visiting an ER.

I repeated several times to the various staff that NO I was not in pain, I was having something like glass in my throat. That and the extreme high blood pressure and dizziness were my symptoms. I did NOT have a 'sore throat' which was mentioned by each staff person I encountered.

They did check my blood pressure, I suppose.
So there's that.

Under Pressure

So about four years ago my BP started creeping up.

My doctor decided I should take medication for it, prescribed some, and I didn't take it. I didn't really get much opportunity to discuss it with her, she left the medical practice and I got shuffled off to the next doctor.

My BP didn't go down. It didn't really go up, either.
Doesn't matter what the numbers were, they weren't great but they weren't scary either.

Going to visit the doctor always started with sitting in a waiting room full of sick people, sensory overload (blaring TVs with periodic announcements about how I need a fucking flu shot and I should quit smoking, neither of which affect me...Nickelodeon for Old People) and an argument with a series of skinny little girls about me getting on the scale.

I think they're interchangeable, those girls,  there's like a warehouse full of cloney little medical assistants with various pastel stethoscopes and cute little scrubs and they just... swap 'em out now and then. I never get the same one twice but they all look scarily alike to me. And they certainly behave the same way.

I'm sure the opening arguments don't help my BP reading.
But the last year or so, it started going up.
And up.

My she-was-new-once-but-now-she's-familiar doctor wanted me to take medication to control it.
I gave it some thought and allowed her to prescribe some for me.

It did not make the numbers lower.
It also made me feel crappy.

I won't give you the whole list, but my scalp itched.
The base of my spine itched.
I seemed to be prone to fungal infections, my feet and other places were driving me fucking insane. I used a lot of foot spray.

I think the worst thing was how it affected my breathing. I looked up side effects, people had complained of 'tightness' but that wasn't precisely it. Digging into my memories of 7th grade science, I decided that the alveoli, which are the tiny little sacs at the end of the bronchial tree, were now sparsely filled with ground glass.
I could breathe okay, but when I breathed deeply, I noticed the little sandstorm swirling around in my chest.

Also, I couldn't sing right.
There wasn't a froggy in my throat, but my voice was a little hoarse and I couldn't hold a note for long. My vocal range was smaller by about three notes in the higher range and possibly five or six in the lower.

It was sort of a pain in the ass if you wanted to know and even if you didn't want to know, well, you know now.

My voice is one of the only things I still have going for me. And while I don't often get it out and share it with the whole world, it's sort of fun to have it and know that (theoretically at least) I *could* share it.

A couple months ago during our weekly grocery expedition, I was telling Eric about my once a week commute to the office and the fact that I used that opportunity to sing karaoke. He made me sing for him. That was sort of fun.
 
I did okay, but I noticed my voice didn't feel right.

So I told her after the four weeks of 'try this and let's see' that I hated the medicine and why.

She was unruffled, changed the medication.

Am I the only one who gets pissed off that you can't get your money back for a prescription that doesn't work? You can get a lamp that doesn't work and take the damn thing back. Or a shirt that doesn't fit. Shoes. Televisions. Whatever.

But a medication that doesn't work or causes horrendous side effects?

Caveat emptor.

Assholes.



The next medication may have improved the side effects the tiniest bit.
Not enough that I'd call it better.

So we tried a third one.

Now I had all the same effects as the other two medications with the added bonus of crazy spikes in BP readings. Not only was it up, it was WAY up. And down and up and down, but never in a normal range.

Also, I started feeling crappy. Tired and weak and not like myself at all.

I went back in and my doctor thought maybe we should increase the dosage.

Silly me. I trusted her.

I felt worse. You'd think I'd have figured out it was the medication, but I just thought I was a little under the weather.

This past weekend I felt really shitty. So I checked my BP about every three hours. Kids, it was fuckin' crazy. A roller coaster. I stood up from my chair in the living room, made it to the kitchen and felt so weak and dizzy I had to sit down for a couple minutes.

So I called the doctor's office on Monday morning.
I told the perky phone person that I was feeling awful, that it was the medication. I told her that I knew a person should not just stop taking the medication, but that I wanted to stop taking this drug NOW.

I told her what some of my BP readings had been and she told me that I shouldn't take my BP so often!

I'm not sure she was aware of the patronizing tone in her voice, but she said, "Your blood pressure fluctuates during the day with different activities, so you should not take it more than every few days."

Um, okay. So we're messing with dosages and something that could kill me and we're going to quibble over frequency of measuring? Dafuq?

She assured me that someone would call me back by the end of the day.

No one did.

Tuesday morning I did a little reading online to try and figure out on my own how to stop the crazy stuff.

I cut the dose in half and took it three hours later than usual. I sent an email to the practice asking for help again. I let them know I found it alarming that a medication that was supposed to help was making things worse.

 

~~~~~~~~~~~~~~~~
I stated clearly that I no longer wish to take this medication.

 

I was HOPING someone might have a few minutes to call me back and explain what steps I should take next in order to stop taking a medication that is obviously harmful to me and making me feel unwell.

 

What I got instead was, "It's not a good idea to take your blood pressure a lot. Your blood pressure fluctuates all day."

I felt dismissed and patronized.

 

Am I the only person who can look at the history of BP readings and see that, although my blood pressure was elevated, it was NEVER like this until we started medications?

This has not made me feel confident about my care.

Wednesday, no one called.
I could have called THEM, but why the fuck bother?
I did the half dose again, an hour later than the dose I'd taken on Tuesday.

I was more than a little pissed off that no one had called, though.

So they got this:

Still waiting for someone to call me back after 48 hours.

What the hell?

 

Man, good thing it's not important.

Or at least not to anyone but me.

 

Is this a new level of care?
Just ignore people until they go away?

Asking for a friend.
The clinic called at 8 this morning while I was still sleeping.
I got one eye open enough to see who was calling, hit the ignore button and sent it to voice mail.

It was my doctor. Included in the message were instructions on how to taper off and then stop taking the current medication.
And the news that she'd be sending a new prescription to the pharmacy I use.

Didn't need the instructions since I took care of it.
I won't need whatever they're going to have for me at the pharmacy, either.
I looked it up.
Nifedipine. You can look it up if you want to.

I don't want to die from high blood pressure but I won't take any more medications for it.

I wondered aloud last time I was in about the heartburn medication that was prescribed to me about five years ago after I lost my voice for four weeks and it turned out to be burned vocal cords from reflux.

"I wonder if that's what's causing this?"

She responded to my concern about the omeprazole by telling me I probably should do a sleep study. I've brought up the heartburn medication before, but she didn't seem to think it mattered.

We're about to find out if it matters, because I've stopped taking that, too.
Even if I have to sleep sitting up until I get used to being without it.

I had asked the wrong question of Dr. Google when I first started taking it, 'omprazole side effects'.

Turns out I should have asked 'connection between omeprazole and high blood pressure'.

Holy crap.

Did you know that some studies have said you have a 40% higher risk of having a stroke if you're taking omeprazole over the long term?
Well, you know it now.
And so do I.

So if you're still with me (and if you're not I totally understand, other people's medical stuff is pretty boring and most of you don't even know me, so double boring) here's where I am.

No more heartburn medication.
Skip tomorrow's half dose of BP medication, take a half dose on Saturday, skip Sunday, half dose on Monday then done with that shit, too.

I hope I don't die from any of that.
I expressed that opinion on Monday when I talked to the clinic but even the fact that I was seriously concerned about my safety wasn't enough to get a call back from them.

I can see why so many older people (odd to consider myself an 'older people' but I will be 60 this year) are labeled as grumpy and unwilling to take care of themselves when what's really going on is the people charged with their care don't actually care all that much.