by – Sheri de Grom
I started this post several months ago and had an entirely different opinion of Urgent Care Clinics. What we’d often called ‘Doc’s In A Box,’ saved Tom’s life on March 23, and they didn’t mention BIPOLAR DISORDER one time. I have a new respect for this segment of the medical industry.
I don’t believe I’m hasty in reversing my opinion. Let’s look at the objectionable facts leading up to this incident:
I’d been unable to reach Tom’s internist for 4 days and Tom breathing was shallower by the minute. His coughing was uncontrollable and none of our old tricks were working. We still didn’t know what was happening to his feet and he couldn’t walk. I’d been pushing him in a wheelchair for the better part of 4 months and tending to his every need for well over a year. I was beyond exhausted and had become a prisoner in our home.
I’d thought nothing could be harder than procuring excellent mental health care for the man I loved, but the playing field became upside down when we each turned 65. The past 8 months had been a living hell on earth as I watch Tom suffer and I knew it was needless.
For 25 years I’d read everything possible from lay books to text books and gained useful insight about Tom’s mental illness. I’d attended symposiums meant for medical staff only and participated in round-table discussions. I’d written legislation to change existing laws and felt confident that I knew what I was talking about and even demanding.
I insisted on what I thought was right from mental health care workers at all levels (including treating physicians), insurance companies, and legislators alike. I wrote legislation and spent night after night in committees until words were chiseled in such a way they could not be changed once they reached congressional vote. I refused to give an inch.
I entered a new area of health care exploration when Tom was hospitalized Sep 22 and diagnosed incorrectly. He suffered unimaginable pain while I searched for answers. Critical functions of Tom’s body were breaking down simultaneously and his doctor of record pumped him full of antibiotics by IV 24/7 with no discernible improvement. Of course, the physician didn’t know if Tom had anything that could be fought with antibiotics. We did not have one conclusive ‘test’ stating this fact.
Tom was in unbearable pain when he was admitted to the hospital on Sep 22 and nothing had changed when he was discharged 8 days later. The doctor sent him home with more antibiotics and pain pills!
I continued my research but the progress was minimal. Seven months passed as we continued to see a parade of physicians wanting to dispense more antibiotics and pain pills. Tom was continuing to fade away and I was becoming more and more frightened. We saw 7 new physicians and not one changed the admitting diagnosis of cellulites yet we still had not one shred of evidence that was what was happening in Tom’s body. More and more antibiotics were prescribed and more and more pain pills. We didn’t want antibiotics and pain pills, we wanted answers!
I’d had enough, on March 23, 2015, one day before Tom’s 67th birthday, I bundled Tom in a heavy coat and drove him to a new Urgent Care Facility (Doc In The Box). It was probably the smartest medical move I’d made in a year when it came to his medical care.
I couldn’t take him to the local ER where we had waited for 8 hours before seeing a medical attendant and were treated as though we were second class citizens.
For several months I’d been researching the provision of the Affordable Care Act which drives the latest boom in new construction which is in free standing urgent care facilities.
On this terrible day, I saw the ‘Doc In The Box’ as a means to an end, immediate care for Tom.
Rounding the sharp edge of their parking lot as fast as I dare go, I gathered Tom from the car and screamed for help as we made our way to the clinic. I didn’t have time for that dang wheelchair. I could get him there faster in my arms.
Where does the adrenaline come from, but damn it, I wasn’t losing him now. I knew somehow this was our last stop between life and death. It was our last hope!
Yanking the insurance cards from my pocket, I tossed them toward the admitting desk and an orderly rushed to help me with Tom. We were taken to a treatment room immediately.
The doctor’s momentum demanded action. Monitoring devises were placed and she barked, “Call EMT for cardiac arrest transport.”
How long did I hold my breath waiting for the man I loved to breathe again? Please, God, not like this.
One moment I heard the screaming sounds of the ambulance approach and before I could focus my tear filled eyes, Tom was whisked away. Time ceased to exist. We were living one breath at a time.
What did I learn from this experience: No one at the Urgent Care or ‘Doc In The Box, was trying to one-up their peer. They worked as a team and were a ballet in precision. The 4 were seamless and the immediate arrival of the ambulance allowed the smooth transport of Tom into the ambulance for his life-saving trip to the ER.
Much of what had kept Tom from receiving the care he so desperately needed over the past 9 months was doctors playing the one-up-man game and political-in-fighting. There were too many egos for Tom to receive appropriate medical care.
I lost all track of time from the moment Tom left for the ER and the time I arrived at the hospital to join him. A staff member asked if I would like someone to drive our car to the hospital and they would give me a ride.
Arriving at the hospital that night, the many times I’d arrived at hospital ERs for Tom rushed through my memory bank. How many times had I feared for his life, how many times had I prayed, God’s will be done?
The ER technicians, physicians, nurses, breathing specialist, cardiologist and the entire medical team worked in unison that fateful night. The primary treating physician told me I came within 3 minutes or less of losing the man I love that day. Why are doctors compelled to tell me how delicate Tom’s health is? I know I’m the one that’s on first. I know I’m the one that must be vigilant. WHY DOES THE MEDICAL PROFESSION GREET ME WITH SUCH RESISTANCE? I’d called 8 times to Tom’s regular providers asking for help as this particular episode turned into a life or death situation.
Is this another case of doctors discriminating against those with a mental illness? Please Lord, tell me it’s not so.
I have a new respect for the new Urgent Care Clinics springing up everywhere since the passage of Obamacare. I’m not saying I agree with how it’s being accomplished or that I like Obamacare, I don’t. I loathe the Affordable Care Act and what it’s done to our health care but on March 23, 2015, it saved Tom’s life. Urgent Care helped us when no one else was interested in providing the medical care we so urgently needed.
In my earlier research, I discovered it’s the few who are making millions on the backs of taxpayers in the building of the Urgent Care Clinics, but that’s the way Obama and Obamacare works!
The intent of the new clinics being built today is to insure health care availability where affordable housing is located. [This is the basic premise of the requirement – accessible primary healthcare for those who otherwise could not reach healthcare unless it was in their neighborhood].
The argument for building and financing the clinics was that with them being built in communities where low income populations with insurance lived; the health centers would drive the cost of health care spending down. It was to be a win-win solution.
A $100 million fund has been established to build community centers near affordable housing as demand for primary-care services are expected to rise. The law includes approximately $10 billion for the creation of new, federally qualified health centers.
As reported by the Wall Street Journal, “[the fund will rely on $87 million in loans from Morgan Stanley in exchange for tax credits to build 500 new affordable housing units and eight new health centers serving 75,000 people.”]
What I’ve noticed in our city is approximately 10 – 12 of these primary care clinics have popped up in less than 18 months. Do they serve a purpose? I must say yes, they saved Tom’s life when I had no other avenue.
Does our city need or meet the criteria for the clinics. The answer is a resounding no. The clinics are being built in affluent neighborhoods when they are targeted for inner-cities. Yes, the clinics are more likely to succeed in a city such as ours where we have fewer than 10 violent crimes per year.
I was less than pleased when I first read and started researching the hidden monies going into the Urgent Care Clinics masked as Primary Care Clinics. But again, they were there when I needed them and they rose to the occasion.
On a separate note, I’ve been away from the blog for many weeks and I cannot promise I’ll be around more than in the past months. Tom has been an extremely ill man and I spend my days and nights caring for the man I love. I think about little else.
I’m delighted to report we now seem to have a correct diagnosis but in the meantime the wrong diagnosis affected his entire body.
Every good ER doc reminds his patient to follow up with their internist or family doctor as soon as possible. Of course, this very thought returned to my 8 previous attempts to do just that before these life-saving measures were required.
We finally saw Tom’s internist on March 31, a total of 6 days after he had gone into cardiac arrest but still the first appointment we could get. Thankfully, I’d advised the ER Doc we might not get in right away and that we had full pharmaceutical coverage. I was giving him permission to write prescriptions for whatever he thought Tom would need over the next week, for fear we couldn’t get an immediate appointment. The doc took my word and we had to use every medication the good doc wrote for Tom.
A miracle occurred as a result of this horrific scare and I do wish we hadn’t had to sacrifice nearly a year of our lives to arrive at the place where we are today but we now have a protocol in place for Tom’s immediate medical needs.
Many of you know I’ve always been able to call Tom’s psychiatrist cell phone direct whenever necessary. I respect the psychiatrist’s kindness but I don’t hesitate to call when we need his assistance. I also provide an e-mail with specific bullet items spelled out for his quick reference of what I’m seeing regarding Tom’s mental health.
Tom’s internist was furious when I explained to him what had happened to us over the past year, since Tom’s misdiagnosis on Sep 22, 2014. He knew the bolts and nuts as Tom’s internist but not the additional issues we’d had in obtaining the medical care Tom needed.
He told us if his nurse did not get back to me within 1 hour of my initial phone call, I was to call his appointment desk and advise them I needed an appointment within 12 hours. It didn’t matter if they told me there were no appointments available. His words, “Tell them Dr. Edwards said to double book.”
Leaving Dr. Edwards office that day, I had hope. Another private cell phone number should the occasion ever arrive when I couldn’t reach him.
Tom’s having some of the same problems today and I just called the doctor’s office. Something must have changed after he bellowed down the hall the day we left, “All staff, conference room now, everyone.”
Today the nurse returned my phone call within 30 minutes and offered an appointment less than an hour out, but I knew I couldn’t get Tom and I both ready to leave the house in less than an hour and be there on time. We have the next best thing, an appointment at 10:30 a.m. tomorrow.
Your prayers and kind thoughts mean the world to me and I try to make the rounds of reading your blogs as often as possible. I love and respect each of you and hope to get back into some routine of blogging soon. This past year I’ve learned more about this health care system of ours than I ever cared to learn. I’ve also learned much about the health care availability in countries around the world and we’ll do a bit of exploring there also.
Thanks for sticking with me. God Bless.
Tell me, what have you been up to lately? I’ve missed each of you.