THE GOOD PATIENT: Dealing with healthcare is scarier than being thrown by a wild horse - The Prescott Daily Courier - Prescott, Arizona
|10/1/2011 9:56:00 PM|
THE GOOD PATIENT: Dealing with healthcare is scarier than being thrown by a wild horse
Terry has been working construction and driving trucks for more than 30 years. She has also ridden rogue horses as far back as she can remember, and once broke a thigh bone in four places when she was thrown. When she broke her wrist one weekend five years ago in another horse-riding accident, she didn't want to waste money by going to the emergency room. She wrapped her wrist and waited until Monday to go see a doctor.
He told her that she'd never work again - nor ride another wild horse - if he didn't operate on her wrist right away.
Scared by this prospect, she agreed to the surgery, but explained that she had what is known as a "paradoxical reaction" to any drug that interfered with her mental state. She had been given anesthesia on two prior occasions. In both cases, when she started to come out of it, she woke up swinging and shouting, ripping out IV lines and throwing things. She was very emphatic: no anesthesia. No mood-altering drugs. She asked for a nerve block, injections into her arm to prevent pain signals from reaching her brain. She explained clearly that she wanted to remain conscious and alert during the procedure.
The doctor stopped talking about anesthesia. Terry said, "I thought that was settled, but it turns out that I might as well have been talking to my bedroom wall."
The day of the surgery, she repeated that she did not want any drugs that would alter her mental state. "The nurse anesthetist said, 'I think I know what's best for you; you're just a truck driver.'" Before she realized what was happening, Terry was knocked out with two different drugs.
After the surgery, Terry recalled, "I woke up screaming and fighting in the recovery room. I was on my feet, in and out of consciousness, throwing things and hitting people. I just went berserk." Terry contrasts her calm state before surgery with her enraged state afterwards. Before the surgery, "It even said on my chart that I was a very pleasant woman in no distress."
For many years after being given drugs, which she had insisted she could not have because of her known bad reaction to mind-altering drugs, Terry experienced uncontrollable rage and PTSD (post-traumatic stress disorder). "I was crazy, and I felt like I was crazy, and there was nothing I could do. It felt like somebody had short-circuited my head."
She said sadly, "My daughter tells me that her mother left home that day and it took years for me to come back. My daughter was 7 years old." In classic "blame the victim" style, Terry was told that she was responsible for the bad experience she had with the drugs: the anesthesiologist said, "You must have been insane to start with."
In addition to experiencing extreme emotional distress, Terry concluded that the operation itself was a disaster. Screws that the surgeon had put into her wrist hadn't been screwed in all the way, and were rubbing against tendons and nerves. Because of improper use of a tourniquet, her upper arm hurt so severely that she stayed in bed for nearly two weeks, felled by sudden slashing bursts of pain if she moved. Her whole hand became numb as a result of nerve damage. When she removed the bandage for the first time, she discovered that the incision cut clear through the tendons inside her wrist. Terry would never have agreed to the surgery if she had understood the risks and downsides.
The surgeon claimed that the operation had gone "perfectly." Shortly after that, he fired Terry as a patient. Even though she was in severe pain from the protruding screws, Terry was too scared to go to another doctor for a year and a half. Then she found a doctor who agreed to take the screws out without giving her the drugs that had hijacked her mind.
Five years after the original surgery, she has about 30 percent use of that arm. She notes, "I can work, but I can't climb ladders anymore. I can't hold wrenches. I've pretty much given up riding aggressive horses, because I just can't hold on." She reports, "PTSD is subsiding over time. I can sleep at night now. I still tend to be more irritable, quicker to anger. (But) it is getting better."
The extreme emotional distress she has endured has altered forever how Terry thinks about healthcare. She will not have a mammogram, a PAP smear or a colonoscopy, out of fear that one of them will reveal a problem and she will be sent to the hospital. "I don't think I can survive. I totally lost my mind. I just can't face it."
This experience has changed how she lives her life. "I used to love riding hunter/jumper horses. Not a chance now: I might injure myself and have to go to a doctor."
Terry fervently recommends that people carefully read "every single line" on informed consent forms. She advises, "Cross out things. They could refuse to treat you. They said, 'We just won't treat you if you don't allow us to do everything we have written on this sheet.' But that's not the law. You don't have to allow them to do any of this. Read it carefully and don't let them rush you. If you have questions, talk to your surgeon."
She concluded, "You need what they have to offer. But you have to figure out how to get what you want, as opposed to what they want to give you. It's your body."
Elizabeth L. Bewley is president & CEO of Pario Health Institute and the author of "Killer Cure: Why Health Care Is the Second-Leading Cause of Death in America and How To Ensure That It's Not Yours." To tell Elizabeth your story or to ask a question, write to thegood firstname.lastname@example.org.