Posts Tagged ‘health’

Part 3: Walter Michka’s journey through major heart surgery in the U.S.

Jun 24 2013

Getting what you pay for?  

Before my near heart attack and subsequent quadruple bypass, I pretty much had one doctor, not counting my dentist— my Primary Care Physician. His name is Joel. I saw him regularly for check-ups and the occasional sinus infection. I went to him with the chest pains I thought were acid reflux, the chest pains that turned out to be a 90% blockage in three of the major arteries to my heart. Joel essentially saved my life when he set up the stress test that found the blockage just before it would’ve killed me.

Now, after my bypass, I’m under the care of two cardiologists: my main one and another one from the same practice who happened to be on duty in the ER the night I came in with an accelerated but shallow pulse. He diagnosed it as SVT (supraventricular tachycardia) so I check in with him every so often.

While my visits are tapering off, I still drop by my psychologist every six weeks.

I see a urologist because Joel discovered I have low testosterone.

I go to a podiatrist to get orthotics to correct the unusual arches in my feet.

I see an endocrinologist periodically because of the benign, but ever-growing, nodule on my thyroid.

Joel’s sent me to a pulmonologist because the endo found a cyst in my lung (I knew about the cyst; I’ve had it since I was a child).

I see an ophthalmologist now that I need trifocals and for that eye infection I can’t seem to shake.

I’ve been to physical therapists because of a rotator cuff and bulging disks in my back.

I get a colonoscopy every five years because they found a polyp two exams ago.

I’m taking, or rubbing on myself, six prescription drugs every day. That doesn’t count the low dose aspirin, fish oil, and other supplements various doctor have recommended.

Medical professionals use “for your age” a lot more now when we discuss my various ailments. Sometimes it’s sort of positive: “you’re doing well for your age.” But mostly it’s: “that kind of thing is expected for men your age.”

My quadruple bypass was my Big Event. Old people have those. My mother’s Big Event was an aneurism at fifty-seven that killed her instantly. My father’s was in his early 60s, his first stroke. He had his second stroke soon after and it was downhill from there. I was blindsided by my Big Event; it came out of nowhere. Now my life is divided into before my Big Event and after.

I’m lucky; I have really good insurance. When I’m checking in for one of my many appointments at the front desk, the receptionist’s posture straightens and her eyes light up when she sees my insurance card. I pay $5,100 every year for this privilege. (That’s for a family of 6) Even with that steep fee, there’s a “co-pay” on top of it, $20 that they ask for up front, before my visit to the doctor or specialist. There’s a co-pay for my prescriptions, too. That can be as little as $5 or as much as $30.

I never quite understood the co-pay. On top of the thousands I’m already shelling out, they need that little bit more. It’s like the ante in a poker game, I guess, or the cover charge at a nightclub.

The bill for my bypass: from admitting me on a Thursday evening, the angiogram the next day, waiting, watching cable TV Saturday and Sunday, the open heart surgery Monday, then recovery the next four days came to $158,000. They mailed us a copy. Because I’m insured, I only owed about 3% of it. Without insurance, I would’ve been on the hook for the whole thing.

In the States, we’ll never deny medical care for anyone who needs it. That’s true. It’s just a matter of how much debt you have when it’s over. Major medical events like mine bankrupt some families. It wipes out life savings, college funds. People lose their homes. It can devastate lives.

We didn’t have health insurance when I was a kid. My dad “didn’t believe” in health insurance, like it was the Easter Bunny or ghosts. He called it “a racket,” paying into a fund you never use. In his case that was pretty much true, it worked out for him. No one in my family really had any major medical problems. The two times I went to the hospital my dad whipped out his checkbook and paid in cash!

Of course, it was 1967 and hospitals didn’t charge sixty dollars for a Tylenol and I didn’t need surgery. Twelve days in the hospital cost just over $376 (I found the original bill). Okay, gas was a quarter a gallon back then, too, but still… They charged us twenty-one dollars for the room each day; an x-ray was five bucks…

The myth is: the more you pay, the better the care, like it’s a cut of beef. But there’s a point of diminishing returns. Our politicians talk about healthcare reform but the likelihood of anything ever getting reformed is slim when there’s so much money to be made. It’s a weird, broken system that really isn’t keeping anyone any healthier. It’s big business and I’ve become one of their best customers.

 

 

 

 

 

 

 

Heart Attacks & Hospitals by Walter Michka

Jun 07 2013

 

When my eyes blinked open after my quadruple bypass, I was in the Intensive Care Unit. I couldn’t move. A plastic tube blocked my view; it went into my mouth and down my throat. Tubes stretched across my forehead, too, taped in place. They ended in a vein in my neck. I could turn my head enough to see my wife sitting by my side. I tried to speak but nothing came out.

There was a nurse buzzing around, checking stuff, changing things. She was a nice woman, blonde, I think, athletic. She was blurry without my glasses. When she saw me looking around, she peeled the tape from my face and one, two, three— slid out the intubation tube.

The next hour or so were flashes, pieces of moments. Eventually, she decided my care didn’t need to be intensive anymore and it was time to take me to the cardiac floor: room after room of people just like me— except older. I said thank you to her as the orderly wheeled me away.

Northwestern hospital sprawls across several city blocks near Lake Michigan among the high-rises of downtown Chicago. With its diagnostic facilities, rehab buildings, and towers devoted to specialists, one for obstetrics, and another one strictly for surgery, it’s a formidable presence. My new home was a corner room, twenty stories up, with views of the city on two sides. It was quiet except for the woman next door who continually yelled at everyone— in Russian.

When they lifted me from the gurney to my bed, I could see three tubes trailing from my rib cage, ending in bulbs filled with bloody liquid. Two wires came out of me, too, actual electric wires that could be used like jumper cables if my heart suddenly stopped. A tube stuck into the incision as well. That led to a box with a button I could push if I needed more drugs.

I’ve never been hit by a car but I imagined it felt a lot like this. Coughing, sneezing, clearing my throat— all hurt. My chest was numb. “Oh, that’s natural,” they told me. “You’ll have some numbness for six months, a year, maybe the rest of your life.” It felt like a big plate or a shield. They kept me pumped full of painkillers, morphine that made me see things crawling on the walls and gave me weird dreams.

The next five days were a blur. Injections and pills and scans. Nurses measured fluids that came out of me— pee from the catheter bag, that red stuff leaking out of my lungs. I wasn’t going to fight them. I didn’t yell at them in Russian. I did what they told me. If they needed blood at 2am I figured they knew what they were doing and I went along.

The nurses taught me a little routine to get out of bed which they made me perform the day after surgery: roll to one side, swing my legs toward the floor, and tilt my top half up until I’m sitting. This way I could eat breakfast, lunch, and dinner sitting in a chair. I could also take walks three times a day around the cardiac floor, gingerly circling the nurse’s station, one, two, three times, then back. Ten or twenty nurses, techs, mostly women, buzzed around, a flock of moms ready to help me if I asked.

Little by little, day by day, they pulled stuff out of me. The catheter one day. The jumper cables, the next.  The day came when they decided I could leave. A nurse yanked the last two drainage tubes from my chest— ready? On three… I could feel them pull through my lungs like a ripcord, first one— zip, then the other. She pulled the catheter from my arm and the sticky, EKG patches off my skin.

My wife helped me get dressed, everything in slo-mo— pre-planned, deliberate movements, easy. Everything tentative. It had been a week since I had worn clothes and I was pretty gamey without a shower. I left a brown patch on the pillow where my head used to be. There was nothing stuck in me anymore, no reminder of what they had done. They gave me a red, heart-shaped pillow to take home. It was a cute way to “splint” myself whenever I sneezed.

A smiling Jamaican orderly performed the customary wheelchair ride to the front door, talking the whole time. I could move pretty well by then and slowly took the ten steps from the chair, through the blast of cold, January air, to the car. I sat gingerly in the back seat as my wife drove us home to spend the next month learning to live my life again.

The worst was over, I guess, but I wasn’t the same person. My life had taken a hard, right turn almost overnight. My world was shakier now, unstable. It showed me what, I suppose, I already knew: that life is temporary and anything can happen. But with the help of my flock of moms I got through it.

Eat Well!

Nov 28 2012

General Healthy Eating Advice

Here are the basic do’s and don’t’s reminders:

  • Make up the bulk of most of your meals with  starch-based foods (such as cereals, bread, potatoes, rice, pasta).  Wholegrain starch-based foods should be eaten when possible.
  • Eat plenty of fibre in your diet. Foods rich  in fibre include wholegrain bread, brown rice and pasta, oats, peas,  lentils, grain, beans, fruit, vegetables and seeds.
  • Limit fatty food such as fatty meats,  cheeses, full-cream milk, fried foods, butter, etc. Use low-fat options  where possible. For example use skimmed or semi-skimmed instead of full-cream milk, or low-fat, monounsaturated or polyunsaturated spreads instead of butter.
  • Avoid sugary drinks and foods such as chocolate, sweets, biscuits, cakes, etc. Limit other foods likely to be high in fat or sugar such as some take-away or fast foods.
  • If you like to eat meat, choose lean meat, or poultry such as chicken.
  • Try to grill, bake or steam rather than fry food. If we do fry food, choose a vegetable oil such as sunflower,  rapeseed or olive oil.
  • Include 2-3 portions of fish per week. At least two of these should be ‘oily’ (such as herring, mackerel, sardines,  kippers, pilchards, salmon, or fresh tuna).
  • Try not to add salt to food, and avoid foods that are salty.

 

Weight Reduction Planning

Nov 28 2012

Now is the time for you to decide if you really have the motivation to lose weight. It is a well proven researched fact that you are far more likely to succeed if what is called your ‘intrinsic motivation’ is clear to you. I suggest sitting down with a piece of blank paper and a pencil, and taking some time to write down all the reasons you want to lose weight. This will help you see for yourself the benefits that you want to gain from losing weight, and support you to make the commitment. Ask yourself some searching questions:

  • What do you think the results of losing weight will be?
  • How much do you genuinely value achieving these results?
  • How do you  feel about losing weight (confident, embarrassed, anxious, determined)?
  • What do other people think about your idea of losing weight, and what influence do they have on you?
  • How easy do you think it will be to actually carry out a six week Losing Weight programme at this time?
  • How much control do you have over your life at the moment, and how likely is it that you will be able to stick to the programme?

Whatever your actual weight and however overweight you are, having realistic goals which aim to lose 4 to 5kg is a good initial target for weight loss. You might need to lose more than this eventually, but losing 5 kg altogether will begin to reduce your health risks, as well as make a huge difference to your well-being and quality of life.

 When you are clear about your motivation and definitely decided that you do want to lose weight, you next need to look at your diary and plan out a six week period. Don’t pick a period when you are traveling or going on holiday, or are likely to be horribly stressed. Try and find a relatively quiet period when you are going to be at home, and can be supported and encouraged by family and friends.

 It is important to be aware that to lose weight effectively, you need to combine eating less with increasing your metabolism through taking physical exercise. Refer to the WELLBEING Physical Exercise Toolkit. As well as make changes to your diet you need to build up to doing do more than 150 minutes ‘moderate intensity physical activity’ a week (see the WELLBEING Walking  Toolkit; between 200 and 300 minutes a week is the goal).

Health Advocates: make your illness a ‘we’ experience

Nov 27 2012

The best journeys are generally those made in the company of somebody else and not alone, and the same is certainly true of the potentially long and arduous journey of a major illness. Whether it is you who are ill or somebody you are caring for , making your illness a “we” relationship with somebody else can transform the experience, provide you with hope when you are feeling down, and help you mobilise all your healing resources.  In fact, having a companion with you who is prepared to accompany you through thick and thin, who can also speak up for you when you cannot find the words yourself, is probably the single most beneficial thing you can do to help yourself when you are ill.

Be bold when asking somebody for help or offer to give it! If you are the one with the serious illness, from the outset try to find somebody close to you who you trust, and you think is prepared to go with you to all your appointments and consultations with healthcare professionals. If you want to talk about the situation with your chosen companion before the appointment and what you are expecting to happen this can be a good idea too. If you have written down your most important questions, you can also perhaps ask them to write down the answers for you as best they understand them during the appointment. Tell them to write down anything else the doctors or nurses are saying if you think it is important, and give them permission to ask for more explanation if something does not make sense to them.

These trusted health companions are often called a health advocate, and I think it is a useful way of describing their very special role in the “we” relationship. An advocate may be your partner, or a family member or close friend, but they may equally be somebody else who you do not know so well, but is able and prepared to take on the role. They can be adults, sons or daughters (if over 16), siblings, parents, as well as friends and even, perhaps, professionals. If you want to ask somebody to be your advocate, the best advice is to trust your intuition and simply go ahead and ask. The prime role of an advocate is to support you. Much of this is practical:

  • Putting out the call for help among your family and friends and coordinating offers
  • Taking care of the home front, and making sure family needs are not forgotten
  • Speaking with healthcare professionals when you want
  • Writing down your medical history as it progresses
  • Helping to plan and organize everything
  • Keeping your notebook of names, dates and places up to date
  • Setting goals and rewards on your road to recovery

A health advocate will also provide healing and hope. This does not require special skills, it is simply about them retaining our humanity at all times, being relentlessly upbeat and keeping a great sense of humour.  If you are ill, these qualities will help you cultivate yours and lift your mood. Having humanity also means that there is no such thing as giving up in their vocabulary. Health advocates can give you courage and will not run away from the challenges, even when you are feeling like doing so. Above all they will always put your wishes first.