Thursday, October 12, 2017

How I became a health care consumer instead of just a patient Part 2

Part 1

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Health care in my family was handled much differently after the death of my grandma. Her primary care doctor had been our primary care doctor.  But after her death and the revelation of her poor medical care, the whole family left his medical practice.

My grandfather came under the care of a new doctor with an office just a few miles from his home.  My uncle didn't really go to the doctor at all. My mother, who had already had a lot of good luck with a chiropractic approach to health care, kept doing that as well as taking a lot of supplements.

My Uncle died unexpectedly eight years after my grandma. One morning he got up with the intention of registering for classes at the local community college. But when he got to the bottom of the driveway, he abruptly stopped the car. My Grandfather went down to see what the problem was and Uncle told him that he thought he was having a heart attack. My Grandfather got an ambulance right away to take him to the hospital where they did a cardiac workup and then admitted him to a room. By that evening, he was resting comfortably. A  nurse came in and asked him if he wanted some juice and he said he did. The nurse turned around to pour it and when she turned back, he was dead. An autopsy determined that he had suffered a dissecting aortic aneurysm. He was only 55 years old.

If he had seen a doctor, this may have been prevented, but Uncle did not have any health insurance. Uncle smoked cigars and he was overweight with a large abdominal girth. When he was a farmer he got a lot of physical activity, but when they sold the livestock and he got a job in town, I'm not sure that he was as active. His death was shocking for all of us and my Grandpa was particularly grief-stricken.

When I was coming up on my own 55th birthday, I did get a test from LifeLine to see if my aorta was okay. It was. I do some form of cardiac exercise at least four times a week, I have never smoked. On bad weeks, when for some reason I haven't been able to work out or walk, my Uncle's sad demise comes to my mind and forces me to get back into it for the sake of my family.

My Grandfather was so desolate after this. He was under the care of a doctor but I don't know if he was ever advised to have a colonoscopy or any other preventive health care tests. He had had his own poor experience with the medical system. A surgeon who promised to fix the tingling in his hands did so, by killing all of the sensation in his fingertips. For a man who had worked with his hands as a mechanic all of his life, this was a devastating development. In the last few years of his life, I thought it was so strange that he had such strong chest, shoulder and arm muscles that ended in the atrophy of his hands and a wasting thenar eminence.

But whatever happened, he didn't have colonic screening. About a year after my Uncle's death, Grandpa started to complain to me on the phone that he was having bouts of constipation. One weekend, Mr. Pete and I went to visit him. We drove four hours and got there on a Friday night after work to visit. We went out to dinner with him and my mother and he ate a hearty dinner. I actually remember that as a very nice time. I had no idea that it would be the last time we would ever all sit down together for a meal.

Sometime after going to bed that night, I heard him call my name from the living room. He said he felt something "pop." His breathing was fast, he was sweating and I didn't like his color. An ambulance came to take him to the local county hospital. The doctor there was clueless about what to do for him. When an attending finally came to see him hours later, it was determined that he would need exploratory surgery. He was moved 16 miles to a hospital in town for surgery. It was determined that he had severe diverticular disease and that one of those diverticula had burst. He was now suffering from septicemia. After two days he was dead. What was supposed to be a long weekend turned into a one week stay for us as we held a vigil at his bedside and then planned a funeral. He was 85.

My mother, sister and I were devastated by the loss of our Grandfather so soon after the loss of Uncle. I'll always remember the hug my mother gave me when it was clear that we were going to lose him. It was as if we clinging to each other and fighting to stay together. I have received three very memorable hugs in my life. Two of those were from Mom. This was one of them.

My mother took a middle approach when planning her health care. As a school teacher, she had excellent medical insurance and she used it. She went for regular health examinations and did all of the preventive stuff suggested for her age group. She continued to see her chiropractor because they were friends and because those treatments made her feel better. She had regular dental visits and eye exams. But mom was also interested in nutrition. She took vitamin supplements and she would always tell me that she was eating this food, or that food because it prevented cancer, or improved health in some way.

I think Mom's approach intrigued me the most. I clearly saw that doing nothing and not taking care of yourself was a recipe for a shortened life-span. I also saw that some preventive tests might be worthwhile. Certainly, if my grandfather's diverticular disease had been caught sooner, he could have had a few more good years.

But Mom's health also had some surprises ahead, particularly after she went back to my father after two decades of separation and became a ranch wife in rural northern New Mexico.

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