It's not what you are eating, it's what's eating you…

Posts tagged ‘#opiatebias’

What this #mhealthfairview expert interview on #CNN is missing about #coronavirus preparedness that can help physicians, other healthcare providers and responders, to prepare better for themselves, patients and the public…

https://www.cnn.com/2020/03/10/opinions/osterholm-coronavirus-interview-bergen/index.html

Important Disclaimers: I am NOT a clinically trained medical or mental health professional, nor do I have any training in public safety.

I will always encourage any person in medical or mental health crisis to be evaluated and treated by clinically trained professionals in appropriate care facility.

Full Disclosure: I am a long term patient in the M Health Fairview system, who has been less than thrilled with my care by some physicians both recently and long term where I’ve blogged about it.

I’m also an Obese, cigarette smoking, non violent (but not wonderfully tempered when met with a lot of judgement) mentally and medically disabled patient with intractable widespread and localized physical pain, who gets a fair amount of a trinity of prescription medications known for abuse or addiction from one long term reluctantly prescribing physician.

I also have neuro deficits that also make it difficult to be concise, this blog isn’t being written to talk about myself, although it will come off like that at first.

It’s meant to help and I’m not honestly being flippant when I say like the novel COVID-19, it will get worse, before it gets better/helpful to not myself, but to anyone who commits to reading it in its entirety.

***

Okay.

Actually NOT okay, on multiple accounts not just personally but concerned as a serious medical and mental health blogger.

So about several weeks ago my lower back pain and sciatica got much worse.

About several months ago my long term physician went on medical leave and I even loathe to talk about it, as to protect their identity, even though I’ve made mentioned of that physician in the past.

In that amount of time which I’ve written about, I had more ER visits in the last 4 1/2 months than I have had in the last 5 years.

First it was Gastroparesis related nearly choking and dying in my bathroom due to uncontrollable vomiting 2 days after Thanksgiving 2019 but being really sick with Gastroparesis stuff the entire holiday weekend and being sick as a fat person still, who had trouble eating and getting fluids in, most of 2019.

Well, Gastric Bypass REVERSAL related Gastroparesis, which for those of us who get it vary symptomatically within that population, as well as those who get Gastoparesis, as they vary, too.

Then I got non diabetic Cellulitis infection that required a ton of oral, IV and intramuscular antibiotics and guess what I got from that?

Clostridum difficile.

This blog isn’t about the state of my digestive system where I’ve already addressed as an activist/blogger the need for longer term followup in Gastric Bypass reversal patients whether or not they end up with Gastroparesis or not.

It’s not even about how stupid but worth mentioning that with my regular PCP who does all my medication management out, that I am being made to go next week in clinic, just to get an renewal of my script for an opiate, as I haven’t had an issue with online requesting meds in any other category even though I’m pretty sure even after a course of heavy duty antibiotics (Vanco) that I still have c-diff.

And here’s where my very unique complex medical and mental health history should help hopefully physicians and other clinical professionals, as well as my history as a blogger/activist who has a 6 continent (the good people in Antarctica apparently know better than to attempt to read my blogs, apparently)  reach about Suicidology and the medical and psychological trauma prior to and after serious bariatric surgical complications can hopefully help physicians and other responders, as well as patients and the public when dealing with novel COVID-19, as far as potential medical and mental health ramifications due to the pandemic, especially in this social media era, as it applies to some of the things that was discussed in above linked video/article.

Yeah, almost 700 words in, and I’m about to make my points, now.

Some of the misguided psychological response to COVID19, is it can’t/won’t happen to me and at least that is being discussed to an extent.

Then there is the issues of bringing up the Obese, as far as novel COVID19 hitting the United States.

Okay, does that mean for all people with a higher BMI over 30, or people who have the co-morbidities that are associated?

What about thin never been of excess weight people who have family history and have diabetes, pulmonary hypertension and high cholesterol and are on medication for it, not just because of their medications but their risk?

How to address that a mandatory quarantine in an acute care facility for those who become sick, also present a potential medical and mental health chaotic danger to physicians, other health providers and responders, in addition to patients and the public themselves, some of it we are starting to see, others you won’t know adverse human response to those circumstance experiencing it, such as suggested in above article?

I’m not, no one in that article is suggesting mass or personal hysteria as a response to novel COVID-19.

But topic fatigue and whole encompassing relentless fear isn’t a good response to the pandemic, either.

I can only hope people need to know, that if there was ever a time, if it’s possible to try in unknowns to tap into what’s good and helpful to ourselves and others, even for those of us who don’t have an “A” game, now is that time.

I may not be the right person to be talking about novel COVID-19, but I think I bring up topics that should warrant further exploration, both immediately and the long term about medical and psychological response to and by and for with good intentions.

A few last things people should be thinking about, whether or not  this pandemic will put them in mortal jeopardy, is end of life wishes, something I’ve discussed in the past, hoping to remove stigma, as blogger.

Such as having Advanced Health Directives prior to potentially becoming catastrophically ill.

Because you shouldn’t wait till a medical crisis to decide important life and death decisions, let alone a matter of life and death decisions.

I have a filed and  updated a very specific AHD, DNR/DNI of not wanting any life saving or life extending measures should I experience any kind of medical crisis (they are void if mental health causes a person to be a threat to their own lives or any other)  over 18 months ago and while truthfully, I think I get treated with more bias than I should by University of MN physicians and the very few physicians I’ve seen outside that hospital system, the U of MN is getting my body, for medical education purposes, as my organs aren’t of any use to any other, when I die.

Other day to day life decisions are impacted for me by disability, and that has to be taken in consideration, if one’s own personal barriers when it comes to having to experience adverse circumstances in life, that are beyond their realm of control.

Again, this blog is being written with the best of intentions to help others.

And I understand that my life circumstances and perspectives are unique, if not a little bizarre.

But, as someone who writes and cares about sanctity of life issues, in and outside of crisis situations, in hopes to conduct myself and help others with dignity and constructively, and it’s my hope it helps others figure out a way that helps themselves and others deal with this, in the most medically and mentally safe way as possible and further discussion on how to help those who are going to be so adversely impacted.

Important Note: Anything that is not constructive to any other or myself will not be posted, I can handle a respectful difference in opinion and welcome that but hateful rhetoric or responses will be handled appropriately and responsibly, so please don’t waste my time or yours by even trying, as no one is forcing you to read anything I write.

And yes, I realize what a weirdly wordy specific title this blog is…

Thanks!!!

An Open Letter to #HennepinHealthcare’s Emergency Department’s physicians…

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Dear Dr. S and Dr. C (purposely not using last names, for physician’s right to safety and anonymity),

I was in your Emergency Department on 1/15/2019, in the morning around 8 a.m.

I understand as I presented as a very unkempt but for the most part, polite 49 year old obese tobacco using patient complaining about a bad cough, but more concerned about the severe left flank pain that occurred every time I coughed or sneezed that a pulmonary issue might take precedence over a digestive one.

I stopped being quite as polite when I checked my tests online and found after almost 3 hours of being there that I only had a urine analysis and pregnancy test, that was run.

I could understand with your facility being a level 1 trauma center that you may not have had time to read my chart, which doesn’t contain much, as I’m a Fairview patient.

Even though I did have a bilateral salpingectomy with endometrial abalation and d/c at your hospital, over 5 years ago and that my chart while not up to date with diagnoses, is update to with medications I am on, which gives an idea of my health issues.

However, while you got Lisa the vulnerable patient yesterday, you’re getting Lisa the activist today, in hopes it helps with others like me, who honestly thought they had an acute health issue and was NOT drug seeking.

This is what I can’t understand and is unacceptable to me, and when things are that way, I try to say something, make it a teaching moment, regardless of the socio-economics, education and profession of those who’s biases effect how I and others, get treated.

NOT every patient who goes through your ED, is looking for opiates, some of us patients who are obese to morbidly obese, have done everything under the sun, to lose weight (hence my side gig as an activist, like one of 3 GLOBALLY, who helps people in medical and mental health trauma with serious gastric bypass complications, on the scale that I do, as well as other medical and mental health activism that I do).

My visit yesterday at Hennepin Healthcare’s Emergency Department, wasted time and money.

It caused me unnecessary duress, because you have patients with barriers that have a propensity to possibly be violent, which caused enormous anxiety.

But the worst duress I experienced, was the assumptions and absolutely NO questions asked about certain things by physicians, that could’ve made my visit a lot more pleasant.

I did see, after I pushed for a blood work up, that were ordered FOUR hours in to my visit, my labs were good.

I also saw today, that I was prescribed a script that was ordered and filled at your pharmacy of high strength ibuprofen when I have a bleeding ulcer history and NSAIDS are an absolute terrible treatment option for pain for me ( and again, I did NOT ask for ANY medications, nor will I get or take script).

Unfortunately, when the IV came out, my vein spurted which wrecked my discharge paperwork and the pants I was wearing and all over my hands and some of the staff was ready to send me home with no help, until another set of staff saw that I was tired and shaky and helped me and I was appreciative of their help.

For quiet non violent introverts, your Emergency Room department is a terrifying place to be.

As I’m sure it is for a lot of people, introverted or not.

For those of us who’ve been labeled  due to mental health issues, it’s even more amplified, with anxiety caused by patients who are violent and fear of medical professionals who’ve labeled me, in the last 17 years, not just for mental health issues, but because I had bariatric surgery.

And while some staff was great at the hospital, what will leave a last impression from what will be my last visit to your facility, is that a busy physicians didn’t take the time to ask me anything, either assuming I didn’t know or wouldn’t be truthful and while you were nice, once I said something about being upset about that, that’s NOT okay.

So please, for the mental wellbeing of your future patients, if they are ambulatory, alert, articulate and polite, don’t label or practice medicine with preconceived notions about a  patient.

Actually, just DO NOT  practice medicine with any preconceived notions about a patient, like EVER.

As in my case, I loathe seeking medical attention and my visit from yesterday made it that much harder, way harder than it should’ve had to be.

As well as it made it more difficult for yourselves, and I have the utmost respect for physicians (as well nurses and all other hospital staff)  of any specialty, but especially for those who work tirelessly and usually without thanks, in an Emergency Room.

So thank you for your time yesterday and today, and hopefully going forward this will help both patients and physicians in your hospital, going forward.

Respectfully, Alissa “Lisa” Kasen

Update: 1/17/2019, when I wrote this yesterday, I tweeted it to Hennepin Healthcare and to my delight, they actually tracked me down and called me, today,  to address my concerns, which is much appreciated.

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