Friday, March 27, 2009

The Keeper of Your Heart

This week one of my cousins died in an accident. There are a whole range of emotions that go along with a 17 year old losing his life, especially when the details involve a speeding motorcycle and lack of safety gear. So many unanswerable questions that all begin with "WHY?" -- Too many whys to contemplate.

The current thing that sticks like a burr in my mind is the story of what happened in the hospital later. After brain death was confirmed and everyone gradually gave up hope for a miracle, staff at the medical center approached my cousin's immediate family about organ donation. His mother consented to donate the liver, corneas, and kidneys for transplant.

But she expressly said they couldn't have his heart. The transplant team asked about it. She refused to let them take it.

My cousin's mother is a nurse who sees the benefit of organ donation in her work. I'm proud she gave what she did. But I am also mystified by the matter of the heart.

Wednesday, March 25, 2009

Medical March Madness (I Win!)

March turned into a tournament of doctor visits. I've been to the gastroenterologist for the initial meet-and-greet, went back three more times for food allergy and bacteria testing, got an upper endoscopy with stomach and intestine biopsies. And today, I finally received test results and diagnoses: gastritis, along with bacterial overgrowth of the small bowel. Oh, and I'm also supposedly lactose intolerant. Woot!

In the grand spectrum of possible causes for belly pain, these are fabulously treatable ones. A few weeks of antibiotics followed by probiotics should solve the small intestine problem. For the gastritis, I can take an over-the-counter stomach acid reducer to calm things down (something I avoided for eons, because my primary care doc initially warned me they might make my pain worse). And since I already stopped eating dairy awhile back, the lactose intolerance is a moot point.

There are real, concrete solutions at hand. I'm not a syndrome anymore. I am simple and clear cut. I win!

Part of me wonders at how slooooow the wheels of HMO-based medicine turn. I went to the doctor the first time for this right before the presidential election, and here we are just shy of April. Meantime I've had pain every single day for five months. I realize it wasn't life threatening pain, but still. It was enough to wear me out and wake me up night after night. And if I'd bought my PCP's boiled-frog pronouncement on the problem, I might be on antidepressants and in talk therapy now! Presumably a shinier version of me, but nonetheless still in pain, since antidepressants and psychologists don't do squat for bacterial problems.

But wait, there's more: My HMO currently refuses to pay for the extremely pricey, specialized antibiotic that my GI Doc wants me to take. So now my doctor's office is having the drug manufacturer negotiate payment of the RX on my behalf. This may take several weeks. If the drug company isn't persuasive, then my GI doc plans to prescribe Cipro instead. Considering the realm of side effects than can come with that super-powered drug, I'm hoping I get the first-choice option. Regardless, at least the end of the stomach-pain era is in sight for me.

Maybe this just shows my newbie status in the world of health care wrangling, but the fact that my doctor and I are sitting on the sidelines while two businesses negotiate treatment seems utterly wrong. Ignore the guy with the decade of medical training or the patient with the infection -- this is all about business, right? We'll just be sitting over here twiddling our thumbs while the firms have their say ...