On Matters Medical

Yesterday I had to undergo a cardio stress test. I had done the treadmill test before, a couple of years ago, and this time I had a test where they inject chemicals into your body to stimulate the heart to pump as if doing strenuous exercise. All the while, the doctors are looking at pictures of my heart via a sonogram (I believe).

They first look at the heart at rest. Then, via an IV, they deliver the stimulant along with a “contrast” chemical which helps give a clearer picture. Finally, there is another chemical that helps the heart recover its normal non-exercising pace. The whole thing took about forty minutes and — apart from the IV which always gives me trouble because I have “fugitive veins” — was completely painless. The doctors, the nurses, and the assistants were all kind and patient and courteous.

Throughout the procedure I had two recurring thoughts — about anti-vaxxers, and the cost of US medicine.

I have heard and read a number of anti-vaxxers explain their refusal to vaccinate by complaining that doctors wanted to “put chemicals” into their bodies, and they won’t allow that. I wonder what they do when their doctor suggests this kind of test? Do they refuse or are they really hypocrites? And how many of them smoke cigarettes, I wonder?

On the second matter I was contemplating while they were testing me, I noted yet again that this procedure was costing me nothing – not a cent bar normal taxes. The same would be true in the UK and most of the civilized world. I can’t imagine what a US hospital would charge, but I bet I could not afford it.

This year I have already seen an endocrinologist, a kidney specialist (twice), my COPD specialist, and a cardiologist; I’ve had this stress test, and I have a full panel of blood work every two months. Before the year is out I will see the cardiologist, the COPD doctor, and visit the Kidney Clinic at least once more each. Total bill — ZERO. In addition, because I am a low-income senior, my various prescriptions, including a lot of insulin, are fully covered beyond a reasonable deductible.

I’m pretty sure I would be dead through penury by now in the States.

A Quiet Summer

Regular readers will have noticed that this blog has been noticeably quiet this summer — quiet in terms of my rantings, at least. We can blame illness and the inevitable processes of ageing for that.

For more than twenty years now, I have lived with what the medics like to call dual morbidities: two chronic illnesses, either of which could kill me. In my case, they are severe COPD and diabetes.  Apart from the occasional chest infection that develops into pneumonia (memorialised in blog posts throughout the years), or a low blood sugar event, I have managed these diseases rather well for two decades, and my regular monitoring results are steady.  Unfortunately, over the winter, a third problem arose.

Between the COPD, the diabetes, and their various medications, my kidneys have taken quite a beating over the years and they are now failing at an alarming rate. At the end of May, my nephrologist advised me that I had entered stage four of Chronic Kidney Disease (CKD) and needed to be monitored more closely. It also means I have have to face up to ongoing dialysis or a transplant or a fatal failure.

Although regular blood tests had shown me that the kidneys were beginning to lose capacity, the deterioration came rather suddenly and the news hit me hard. As I mentioned before, I have spent years “managing” both COPD and diabetes; but now there was a new threat that I had no idea how to manage. I might have been able to deal with that intellectually except that, coincidentally, on almost the same day, I was struck down by a pneumonia-like chest infection that laid me flat out for a week, and eventually lasted about a month even after I started aggressive drug therapies.

During those first few days, when I could hardly move from my chair without becoming totally breathless, and when my mind was swirling about the kidney issue, I made a decision to withdraw from public life and concentrate fully on looking after myself. I pulled back from much of my activity on Twitter, stopped attending meetings, and withdrew from some new responsibilities, at the People’s Coop Bookstore, for example.  I assumed that I would be spending a lot more time on blog posts. But for the first few weeks at least I could not concentrate on a topic long enough to write about it, and so that too became neglected.

I still spend most days at home — the hot weather and smoke have helped trap me indoors — but my chest is much improved and I’ll start to get out and about again.  In a couple of weeks I meet with my new team at the Kidney Clinic and we’ll see what has to happen then.  In the meanwhile, I hope to get back to a more regular schedule of writing soon.

Thanks To BC’s Great Medical Folks

Regular readers may have noticed that I have not been writing much original material in the last few weeks. I apologize for that for anyone who may have missed my usual bon mots.  The fact is I have been really rather unwell since the beginning of September and have had neither the energy nor the inclination to write.

Without going into the unpleasant details (definitely unpleasant for me to remember!), suffice it to say that I was suffering severe pain for the entire month of September and the beginning of October, and required the assistance of EMS once plus three other trips to Emergency. As I went through it all, I had used the services of my GP, Respiratory Therapists, endocrinologists, urologists, Kidney Specialists, emergency doctors and nurses, and all their  ancillary staff.  At the end, I was still undergoing my experimental COPD treatments and so also engaged the services of surgeons, IV specialists, anaesthesiologists, cardiologists, and all the rest.  It was, perhaps, the worst five weeks of my life, medically speaking.

But the point of me writing this is to say that without exception, I was treated with enormous skill and devotion, with humour and courtesy wherever possible, by every single member of the BC medical fraternity that I dealt with. I tried my best to be a good patient but the level of pain sometimes made that difficult but never was I scolded or given anything but the greatest respect. In the end, they figured out what needed to be done and they did it.

And because this is the civilised world and not the USA, no-one ever asked me for money.

I also have to thank the ever-loving who was there every day for me, keeping me going, and some good friends who were willing to whisk me off to emergency when I needed it.

Now, I hope, normal service will be resumed!

Twenty One Years And Counting

Yet another year without cigarettes. Twenty-one years today, wow.

It might seem tedious to keep harping on this year after year, but frankly I think giving up smoking after 35 years of slavery to the habit was the smartest and bravest thing I ever did. And I know for a dead certainty that I would not be here writing this today if I had continued smoking the way I did.  So I’ll keep celebrating my freedom, year after year!

And this year is even more special as I have joined a very select few having the chance to clean up their COPD with an experimental treatment that involves scrubbing the lungs, under general anaesthetic, with liquid nitrogen. I had the first of three treatments 10 days ago and already feel my breathing is somewhat easier. By the beginning of November I will have had all three procedures and then we will see. I have high hopes. And it makes those 21 years of denial all the more worthwhile.

Cannes Lions Winners

The Cannes Lions Festival is always worth watching for those interested in creativity and technique in marketing and advertising. Some of the very best creatives and film makers link to produce wonderful short works.

There is always some controversy to keep us interested. As Creative Review’s piece on Cannes discusses, a few pieces were withdrawn even after prizes were awarded.  The same report lists all the winners.  Terry O’Reilly of “Under The Influence” attended Cannes and his blog has some interesting discussions.

Here are a couple of prize winners that I found particularly special. The first is a 3-minute piece from the Spanish lottery corporation that is beautifully made and has a heart-warming message.

 

The other has a personal meaning to me, suffering as I do from COPD. It is called the Breathless Choir:

Beautiful and creative stuff.

Thanks For BC’s Great Health Care

For a guy with COPD like me, winter can be like crossing a frozen lake; most of the time it is perfectly OK, but sometimes thin ice in the shape of heavy cold can send you plunging into the depths.  So it was this last weekend as a cold developed into a chest infection and I was suddenly in serious trouble.

I spent the last four nights in St Paul’s Hospital — and I have the bruises and puncture wounds all over my hands and arms to prove it!

Now, I don’t tell you this to garner sympathy — although get well cards including suitable financial tokens would of course be welcomed.  No, I write this as an excuse to once again praise the extraordinarily fine medical system we have in Vancouver.

My wife called 911 at about 3:30am and within five minutes we had half a dozen eager and thoroughly professional responders in the house, along with enough equipment to support a man on the moon.  They did everything possible to make me comfortable, keep me and my wife calm, and deal with all the consequences of restricted breathing.  They were all magnificent.

With 30 minutes I was downtown in St Paul’s trauma unit and in the hands of an equally proficient and pleasant suite of emergency doctors, nurses and technicians.  Once again they did all they could to stabilize and improve my medical condition; and, like the EMS folks before them, answered every question clearly and immediately.  It is this interaction with patients on a human level — and which continued throughout my stay on the ward — that I really appreciate.  It is so widespread throughout the Vancouver hospital system that it must be an integral part of their training — and it is wonderful.

This emergency is the first I have suffered since 2004, but in the early years of the decade I was in and out of St Paul’s and VGH on an annual basis with pneumonia and other COPD-related complications.  On each occasion I got the same incredible treatment as I did this week.  I hear so many complaints about Canada’s and BC’s medical system that I just have to shake my head in disbelief about what people must expect.  I simply cannot believe that I am the randomly fortunate one.

I’ve said it before and I’ll happily keep saying it — the BC medical system as represented by our Emergency Services and our major hospitals in Vancouver is world class and I am proud to say it is ours.