Thursday, May 24, 2007

Health Care in the US

Warning - this post will get a bit graphic, if you're squeemish, you might want to skip past the pictures.

The scene:
So last night as I was watching American Idol I decided to work on my quilt a bit. I was unhappy with one of the fabrics I'd already cut out for the sashing so I was going to cut a different piece out of this one. It was late, I was tired, I was paying too much attention to the TV and not enough to the rotary blade. As I ran the blade through the fabric I managed to slice my finger! The blade is sharp so it didn't even hurt at first. But when I looked at the mat I saw a little chunk of skin laying there and I knew it was a *bad* cut!

So I did what I do in situations like that being the overly educated and intensely practical woman that I am. I got out a first aid book and read what you're supposed to for a bad cut, (after of course swearing loudly, and grabbing a tissue to press against my finger). It said to keep the cut elevated and maintain steady pressure for 15 minutes before looking to see if the bleeding had stopped.

I did this, watched the end of AI with my finger elevated on the back of the couch, pressing hard on the tissue with my thumb. But after 15-20 minutes, when I looked again, it was still bleeding. I started to panic a bit because, while I knew it was just a finger - still it's a bit unsettling to watch yourself continuing to bleed after that long. I decided to call my Dr.'s office to see what they said. There was a number on my Dr's card that said "Emergencies" so that's what I called. And this is just the quintessential experience of the bass-ackward US Health Care System.

Health Care Worker #1 "How may I direct your call?"
Me "Um... I think I need to talk to a nurse - I've cut myself and I can't stop the bleeding"

(now -being naive I had expected something like "how big is the cut" or "how much are you bleeding?" you know - so they would know if I was in immediate peril - how mistaken I was!)

HCW #1 "No, we don't have what you would call advice Nurses, and even if I could let you speak with a Nurse, it's against the law for them to give you any medical advice, because they haven't seen you."

Because - what I really needed at that moment was to be treated as though I were trying to engage in illegal behavior. Like I was some kind of junkie working the system to get morphine or something..... against the law to get advice from a nurse....

Me "Um... ok but who should I talk to? I need to know if I should come in to the ER or if it's okay"
HCW #1 "Well, we can't tell you that, but I can transfer you down to the ER and you can talk to someone there"
Me "Ok thank you."

HCW #2 "Hello how can I help you?"
Me "Hi, I've cut myself and I can't stop the bleeding, but it's just a small cut so I don't know if I need to come in or if there's something I should try at home"
HCW #2 (who I must say had a much more sympathetic tone than the first gal, but still) - "I can't tell you if you should come in or not, I'll leave that to your judgement"

At this point I'm getting kind of upset because I'm up way past by bedtime and I'm bleeding and just need someone to tell me what I should do, and right now my judgement is the last thing I want to rely on!

Me "I just need to know if this sounds serious or not"
HCW #2 "I can transfer you..."
Me - click. Because at this point I'd become a bit irrational and extremely upset.

On the one hand, it's late and I'm in my jammies and I don't want to go down to the ER and sit around waiting to be seen only to have them look at my little finger and laugh. But I also don't want to go to bed and slowly bleed to death. And I'm starting to get a bit hypochondriacal and afraid that I'm going to go into shock because my first aid book says that you can go into shock from even an minor injury and if not treated shock can lead to DEATH.

I tried to pull myself together and think "What would the Pioneers do?" Because you know I love doing things like the Pioneers did. And I thought people have been hurt way worse than this in various wars, and survived. I'd just need to bandage it up really good. So I went to the bathroom and started putting band-aids on. First one over the cut, then one to make sure the first one stayed on, then another just in case, and what the heck I have a whole box of band-aids here.

5 bandaids later:

Then I decided to call J. becuase I knew she'd still be up. And when I told her I cut myself her response was not "Let me transfer you." or "It's illegal for me to help you." but rather "Oh no! Are you okay?" which is why I love J. She did a very good job of calming me down. And also reassured me that if I did go to the ER they wouldn't laugh at me. In fact she relayed to me a story of her friend who went to the ER because he'd gotten his I-pod ear bud stuck in his ear and couldn't get it out. And another time he went to the ER thinking he was having an allergic reaction becuase he'd had a rash, but it went away. And that really made me feel better, because at least in my case there was actual blood involved.

I think my problem is that I watch too many hosptial-based TV shows, and I think the only people who go to the ER either have limbs missing, some rare and lethal tropical disease, or a pick-ax stuck in their head. I didn't realize that people went to the ER for minor things like getting an I-pod earbud stuck in their ear.

Anyway after talking to J, I felt significanly better, and no longer thought I was going to bleed to death in my sleep. When I got up in the morning, I showered & took off all the band-aids. I was glad I'd used 5 because I'd actually bled through the first 4. But it looked like it was done bleeding. I cleaned it off a bit, put some antibiotic ointment on it and put a few more band-aids on. I think I'll survive. Here's the gash this morning. I don't think the photo does it justice because it's hard to see how deep the cut is, but you get the idea.

When I told my coworker Nurse J. ( not actually a nurse, but she's planning on it and has taken First Aid & a bunch of anatomy & physiology classes) about it this morning she not only expressed a lot of motherly sympathy "oh you poor thing, your poor little finger" but she explained to me what my white blood cells were doing, and about the inflammatory response. I think Nurse J will be a good Nurse. I just hope the system doesn't ruin her.


Cindy in Happy Valley said...

Fingerpads bleed like sonsaguns don't they? I cut myself in a similar way, and now I have a lumpy finger, with a little numb area. If you wait longer than an hour or two or maybe four, the ER will just give you a tetanus shot and look for infection. It's too late for stitches etc. You'll be fine.

Rebel said...

^^ and that's exactly the kind of thing that would have been useful to hear last night "you might want to come in for a tetanus shot". Thank you! I'll call my Dr. and see if I'm up to date.

Sue, aka seiding said...

Ooh, ouch. There's a bit of unreality when you injure yourself like that isn't there? I cut my thumb open at work once with a really sharp knife, and I couldn't understand where all the blood came from--I hadn't even felt it. I ended up driving myself to the doctor and getting three stitches, one right through the thumbnail! But I remember looking at it, thinking, hmm, there's something wrong here. Hope it heals fast and you're back in commission soon!

Bets said...

Dang, that sounds like no fun at all. I love the pioneering logic, however, and completely sympathize with your lack of desire to head to an ER (unless it's the one at Seattle Grey cause I'd have those hot docs treating every tiny ailment if I could!)

Sarah said...


That's horrible.


Magatha said...

Sorry I can't read about it. I have a real phobia about knife and scissor cuts. I get physically ill when I see someone with a cutting impliment and they are not paying full attention to what they are doing. This condition is due to all the times I've cut my hands badly with knives and scissors by not paying attention. So proud of you for 'dealing' with it on your own. The first thing I do when this has happened to me is faint.

Magatha said...

I got the stones to read through your story and I must say, I am seriously impressed at your ability to deal with all that blood. I've had cuts like that, a scissors cut that was especially deep and I've not had stitches. I've had the benefit of a former hockey player in the house to advise me as to the 'seriousness' of cuts.
Good grief, I hate the state of our health care. Trouble is, I don't know how we'll get out of it and on to something better.