You Know Your Body As Well As The Doctor - Listen To It
Why are we always so quick to surrender authority to someone else when it comes to decisions about ourselves? Specifically why is it that as soon as we are in the presence of a person in a white coat we automatically assume they know more about our state of being than we do ourselves? Wouldn't you think it would be the opposite, that we are going to know how our body reacts in certain situations far better than someone who has only met us once or twice?
"Nobody has any problems with that…" or my personal favourite, "Now that's strange I've never seen that before… are you sure you've done everything I told you to do?" Implying that it could never be there fault that you've swollen up like a bright red balloon after having an allergic reaction to something, something that you had warned the doctor about to which he had replied "Nobody has any problems with that"
I've had sort of a hit and miss relationship with the medical profession over the years, I've been accused of exaggerating the amount of pain that I'm in after knee surgery by some arrogant prick of a resident and been told to stop being a baby and that they're going to send me home. Then when he goes to recast me (whoever had put the cast on after surgery had forgotten that there might be some post surgical swelling and my circulation was cut off so badly my toes turned black until they got someone to loosen the cast) he discovers an infection in the incision that would account for the amount of pain I was in. Oops the patient was right not the doctor.
The latest fad in hospitals is to reduce stays as much as possible. All in the name of the almighty dollar; get that patient in and out as fast as possible, or heck, don't even keep them if we can help it. Let the family deal with them at home. So what if they can't walk. Procedures like gall bladder removal, hernia repair and appendix yanks that used to require a minimum of a day or two in the hospital are now Day Surgery, in and out the same day, or at best an overnight stay.
To be fair the doctors don't set a lot of this policy, it's just the guidelines they are forced to follow by the hospitals. I'm sure they were asked what, under ideal conditions, was the minimum amount of time needed for recovery for each of those procedures, and were then instructed to adhere to that schedule. My complaint is that perhaps the doctors could take each patient into consideration as an individual instead of treating us all as a singular mass.
I believe that these new guidelines are probably costing them more money in the long run than if they had kept the patients in for the amounts of time they had previously. If they were to examine the numbers of patients who have to come back to hospital within days of being released and be readmitted or treated for extensive time in emergency they would probably find they are spending the same if not more money on patient care now then they were before.
Let us use me as an example. Friday morning just past I went down to the hospital to have a hernia repaired. This procedure that used to involve a hospital stay of a couple of days is now done in Day Surgery under a local anaesthetic. You don't even get knocked out anymore. Perhaps for somebody who is in perfect health and has no other complications at all they are able to go home a couple hours after the surgery and be fine.
Now the doctors were well aware that I have a pre-existing chronic pain condition in the same vicinity of my body but didn't seem to think that warranted any special consideration. So I was sent on my merry way an hour after surgery was over. By mid-afternoon I was in so much pain I couldn't move. None of my oral analgesics, 10-mg. morphine pills taken two at a time, were giving any relief at all.
In the province of Ontario, Canada where I live we have a twenty-four hour health line that we can call to speak to a Registered Nurse at all times for a quick consultation. When I phoned that line at 7:30pm that night she told me she would check with a doctor on call and either he would phone me within a half hour or I should get to emergency as quick as possible. Fifteen minutes later they phoned back to tell me to go to emergency at a specific hospital and they would be expecting me.
I was at that hospital until 1:30 am and during that time they pumped as much morphine into my body as they could in an attempt to bring the pain under control. But because they are not an in patient hospital they had to ship me by ambulance to another hospital across town. There was a surgical team on call there who needed to examine me in case I was bleeding into my abdominal cavity or my wound.
I ended up staying there until 2:30pm Saturday when they finally managed to get the pain under control enough that I could lay at rest in comfort. The conclusion that they came to was that because I suffer from chronic pain already, my tolerance for pain is less than other people's and conversely my tolerance for morphine is higher. If I had spent the night in hospital receiving proper pain management to begin with, there never would have been any of these problems.
So I ended up taking up two beds in emergency, one in each hospital, an ambulance ride, between the two hospitals, a huge amount of intravenous morphine, and finally a bed they had to book for me in case they needed to admit me to the hospital. (When my wife phoned looking for me on the Saturday afternoon as I was heading home in a cab she was actually told that I had been admitted and was passed up to the room I was supposedly in. It took her talking to six people to find out that I was already in a cab on my way home)
What is disturbing is that I'm not the only person that this happens too. Even if you cut the hearsay accounts in half concerning people who have been released from hospital and then had to be rushed back in again a few days latter, the numbers are too high. Of course there are bound to be a few people where unavoidable complications occur after the fact, but for so many people to have to be readmitted there is something wrong with the system.
Doctor's have to stop treating people like they are all the same and to not treat anything as routine. Cutting a human body open is never routine, especially when you are inserting a foreign object like a piece of mesh in the body as they do for hernia repair. If they have any doubts about a person's ability to recover they should automatically be admitted to hospital and err on the side of safety rather then expediency.
But the responsibility is also ours as patients to ask questions and make sure that all our concerns our being addressed. I don't know if it would have helped or made a difference if I had reminded people about my other condition, or asked for assurances that it wouldn't make a difference in my recovery. But I should have trusted my own knowledge of my body over that of the doctor's opinion and at least tried to say something.
Until we have the courage to take control of our own bodies and reduce our dependency on someone else's opinion on how we are feeling, we will continue to find ourselves in situations that might have been avoided. Of course it also depends on the willingness of the doctor to listen to you. But if fewer of us were to treat them like gods, perhaps they would stop thinking of themselves as ones.