I have made no secret I have health problems related to my service in the United States Army, and health problems related to the treatments I have received for my service connected disabilities. I have a myriad of physical ailments, most of which are painful. Most of the time the pain is tolerable, or what I have learned to call tolerable, but the past two weeks have been very difficult for me. I have been in terrible pain. I am hesitant to go to the hospital due to all of the hospitalizations I have had over the course of my adult life; hospital stays that went into months, with recoveries taking years, at a time. I hate the hospitals, so please understand why I try so hard to stay out of them.
When my pain kicked into high gear a couple of weeks ago, I had no Primary Care doctor at the VA Clinic to call, and explain what was happening. My new Primary Care Doctor, who had just taken my case 7 months ago, and had just started to understand the impact of all of my health problems on my body, up and quit, with no notice. Had I called the VA Clinic, I would have been passed of to Lord knows who; furthermore, they would have been totally ignorant of what is being done for me, and would have made a cursory judgement, based on one visit, and possibly jeopardized my health. I have been down this road before, with another doctor trying to do what my regular Primary Care Doctor does, and had everything get off track, leaving me in a worse state than when I went in.
I held on because I knew I had a speciality clinic appointment coming up, and I would at least have access to professionals familiar with my case. I also held on hoping I would get better. I made it to my appointment, it was last Friday. The nurse knew right away I was not feeling well, and when I got a bit ticked over something an NP said to me, something that normally I would have corrected her over, and moved on, they all knew I was not feeling well. I asked the nurse where I was receiving my treatment to contact my other specialist, over their intranet, tell him I was having a flare up, and need a certain medicine to calm things down. She tried to get in touch with him, but he is very busy, and sometimes cannot get back to anyone until the next day. An end run was made for me, and the NP, who I had just got ticked off with, told me if the other specialist had not called back, in time, she would write the prescription for me because it was obvious I was having a flare up.
The prescription was written, and while I was waiting for it, my other specialist called. This was fast for him, because we had messaged him only a few hours prior. I briefly explained I was having a flare up, and needed the meds to calm it down. I told him the strength required (I know about the treatments this), he replied “no problem”, went down the list of things to watch for, and said he would add a note to my chart reflecting our conversation.
Everything worked out fine, but I should not have had to circumvent Primary Care, because they cannot keep a decent doctor on staff. The entire Primary Care system is built around the Primary Care Doctor. The Primary Care Doctor is the Quaterback of the team. They get the ball, and pass, or hand it off to the appropriate speciality. Sometimes, if they are familiar with your case they will make the call on the spot to prescribe the usual course of treatment, and send a note to the specialists reflecting their decision. Seeing how I had no Primary Care Doctor who knew me, I had to be the Quaterback of my healthcare team. For me, this usually turns out okay because I am so familiar with my case, and have been dealing with all of the problems I am diagnosed with for decades; however, I am not the average Veteran.
Most of the guys would have suffered silently, or went to the ER. Suffering silently, while heroic, is dangerous, and going to the ER for something Primary Care should be able to handle is a waste of resources, and the Veteran winds up being admitted needlessly, or labeled a malingering drug seeker. Do not let me get started on that. Suffice it to say that Veterans Administration‘s Emergency Room Doctors, and Nurses need to get it into their brains that every Veteran walking through the door, stating they are in pain, are not there with the sole intent of getting pain medications. We are there because our bodies are telling us something is wrong, and we are unable to handle it at home, nor are we able to wait for the Clinic to open.
Well, I have been on the meds for the flare since Friday, and am having very small results. I truly believe if I am no better tomorrow, I will wind up going to the Emergency Room, and running the gauntlet. However, I may dial-up my specialists, if I think I can wait another day for a call. All I know is this is very painful, I have been through it before, and the hospital course for it is so difficult, and hazardous, it should enable me to be eligible for combat pay.
Much of this could have already been handled had I been able to see my Primary Care Doctor. One who knows me, and has worked with me, and on me. Taking the luck of the draw, on a walk in Clinic appointment is dangerous at ALL Veterans Administration Clinics. You could wind up having your entire treatment plan screwed up, sent for needless tests, and/or even worse things, life threatening things, could happen that I will not write in this blog entry.
My thanks to Amy, Ruth, and Tom, at the Veterans Administration Hospitals for helping me in this time of health crisis. I am very thankful to have such highly competent people looking out for me. Now, if I can just get another good Primary Care Doctor, who will learn my case, and work with me, as a partner in my healthcare, things will be great!