Sunday, November 27, 2016

Propofol: the Lesser of the Evils

I wrote about the miracle of Propofol and want to talk about that a little bit more.  Propofol was a miracle drug for my daughter.  Would I allow Propofol to be used on me?  Maybe, maybe not.

I have read way too many articles talking about the "patient cooperation" with Propofol.  To me, that doesn't sound like "asleep."  Sorry, I find that disturbing, especially after the Versed debacle.  The "amnesia" didn't work for me with Versed and the absolute HORROR of being unable to move or speak efficiently and the crawling subservience to the medical minions every whim was more than I could deal with.  If I could describe the level of freakiness for you I would.  Follow that with waking up from the general anesthesia I had FORBIDDEN, on my feet trying to kill people with my cast, I have a very deep issue with any drug which renders you obedient, incapable of stopping the procedure and which produces a profound personality change.  Since NOBODY will tell the truth about these drugs, I have a hard time swallowing the happy clouds descriptions.  "Superior patient cooperation with Propofol" comes close to sounding like Versed, only worse.

I saw the results of using Propofol on my daughter and it was an incredible drug.  Would it be safe for me and others who have already had a problem with Versed?  I-don't-know.  Depending on the medical issue, if Propofol were the least of the anesthesia options I would choose it.  MAC is out of the question as is general anesthetic.  I have had very good results from regional blocks without sedation so that would be MY first choice.  Performed by a doctor of course.  For more invasive procedures which cannot be performed with a block, then Propofol.  The thing is, for people like me, all this sedation, MAC and general anesthetic is complete overkill.  Why would we need all this crap for some minor procedure?  It boggles the mind.

I would accept Propofol as a last resort only.

PS  After the debacle with my distal radius fracture (see the "vast improvement" in the x-rays, which is actually minuscule. Keep in mind that I reduced that fracture on my own before I ever saw a doctor...) If I had the same fracture as my daughter, here is my plan...I would tie a rope around my wrist, then shut a door over the other end of the rope about shoulder height and pull until I could tease the widely displaced ends of the bones together again.  The roughness of the fracture will help hold the bone ends together.  A nice brace to hold that shoulder back until it healed and voila, problem solved.  If you can't handle that, Propofol might be a good choice so the medical people can fix it for you.

Saturday, November 19, 2016

Obamacare Again

Obamacare is an unmitigated disaster for people like me.  In order to supply insurance for the few, the many have to pay for insurance they can't use.  Don't believe me?  Look at the numbers.  The "Patent Predation and Unaffordable Care Act" has allegedly insured 15 million people.  How wonderful.  Out of 315+ million people, but at what cost?

My premium, paid by my employer in lieu of wages, is $9.84 per hour.  Let that sink in.  My health care premium is more than minimum wage.  It amounts to at least $400 per WEEK!  It continues to go up, 6-8% a year and the deductable is up over 1100% since this monstrosity was passed.  The more the premium is, the less money I take home.  This premium now swallows almost 1/3 of my hourly wage.  What do you think I get for this expensive coverage? (besides getting to subsidize the people on Obamacare)

I have a new $500 per person per year deductable out the gate, per calendar year, before the plan pays anything.  There are three of us, so a maximum of $1500 per year deductable before anything gets paid.  This is new this year.  It had been an 80/20 split until the NEXT deductable was met.

The next deductable is $5,000 per person per year, but they don't call it a deductable this year.  This year it's called "co-insurance."  The plan brags that this is payable through the 80/20 split.  The fact is, one visit to the emergency room will result in a $5,000 "co-insurance" payment, after the initial $500 "deductable".   So $5,000 per person per year and the $500 per person per year.  $5,500 dollars per person or $16,500 for the family.  There are lots of exclusions, so this number will be higher if we have a catastrophe or a serious of medical events.  On Jan 1 all of this resets.  I don't make the kind of money where this is in any way "affordable."  Especially not after the premiums are taken out of my check.

About that "co-insurance" in the previous paragraph...  Know what "co-insurance" is?  It's patient responsibility.  In the new American way, words and meaning are changed to suit whomever is trying to obfuscate the issue.  *I* am now an insurer.  I am curious as to what that designation is designed to do?  Is it simply to deflect or is it something more sinister?  As a "co-insurer" are there going to be tax issues in the future?  Am I going to be forced to have "capital" for my (co)insurance company or face fines, fees and penalties?  More forms to fill out?

So I have this fine, expensive insurance which is basically a major medical plan that I can't afford to use.  The government is salivating over the luscious taxes they can impose because of the "in lieu of wages" designation.  Now I wonder if the "co-insurance"verbiage will create new problems for me? With my salary, after all the bums get through with it, puts me at 130% of poverty level.  Slightly more than half my income goes for taxes and health care.

Maybe somebody can explain how this can be called a "Patient Protection and Affordable Care Act." Can the Obamacare people use their insurance?   Or are we all forced to pay for insurance we can't use, to bail out the health care industry?

Friday, November 18, 2016

Another Person With a Successful Foray into Medicine

This came in my emails at  I love a happy ending, so I'm sharing with permission of course.


"Hi Jackie

I contacted you last year about how I've had colonoscopies without sedation and how, to me, they are painless.  I wanted to relate to you a surprising experience I had this past Friday.

On Friday, I had joint replacement surgery on the big toe of my right foot.  My doctor told me she normally does this surgery under MAC.  So, I was prepared for the usual fight about no Versed with the Anesthesiologist.  However, the Anesthesiologist spoke with me for a very long time, listening to my concerns and history.  He recommended, based on my history, GA, and he absolutely assured me that Versed would not be used. 

No one tried to put anything into my IV prior to going to the OR, and in the OR, clearly visible to all, was a huge white board with my medical history listed.  In the middle of the white board, in big letters, was "ALLERGIES - VERSED".  The feeling of relief I had seeing those two words was indescribable. 

The surgery went well and I am now recovering.  I was very lucky to have the Anesthesiologist I had for this surgery."



My daughter broke her collar bone 6 weeks ago.  As you can imagine, she was terrified that I would let them give her Versed OR that the anesthesia provider would simply defy me and give it to her anyway.  She had to deal with me for several years after my debacle with Aaron, the crna who gave me Versed against my will and against my instructions.  She was afraid that would happen to her...

First she witnessed me refusing to sign the intake documents.  As I have admonished people, take the time to read the contract.  Since this IS a contract it is within your rights to strike whatever it is that they want permission for.  In this case it was a blanket consent to allow anybody they chose to do whatever they wanted, in direct violation of informed consent law.  Never give up all control and your rights as required by law by signing anything of the sort.  Then I quickly crossed out any consent for video recording the procedure.  NO!  So the witch (with a "b") said that they would not perform the surgery if I didn't sign the paper without any alterations.  The fight was on.

In those documents, there are phone numbers which I began calling.  I am not forced to sign a blanket consent before treatment.  An "informed consent" is different.  That one has details in it REQUIRED BY LAW and also REQUIRED BY LAW is your right to refuse any part of the proposed treatment. That doesn't come with a caveat, sign this or else.  That is coercion and is specifically forbidden BY LAW.  I did get hold of somebody who wasn't such an idiot (and had some authority) and ran down the abusive, arrogant and dismissive behavior of the intake minion.  Problem solved.  I simply said that their intake form was unacceptable, illegal and it would be irresponsible of me to sign it.  The hospital took the offending document, with my lines and scrawls and without my signature and we proceeded.

It is YOUR RIGHT to have an actual doctor instead of an anesthesia nurse.  You may demand that.  I did.  While I was discussing my daughter's anesthesia with the anesthesiologist, a crna popped into the room (he had a name tag which described his lowly role) and I hissed at him and held up the universal sign of getting rid of a vampire, in his face.  You know the one where you form your index fingers into the sign of the cross?  He disappeared instantly.  Thanks little crna.  I'm glad you didn't stay and fight with me.  Maybe he didn't like me mentioning Aaron's (the crna which caused my problem) full name?  Whatever, he left precipitously.  Maybe he was a nice guy, he might have been professional and respected our wishes, but judging by Aaron's treatment of me and the scornful way the crna's who come here have treated me, I won't take any chances.

With the exception of the original intake person, everybody else was accommodating and very pleasant.  They defused what could have been a major ordeal and I was very pleased.

I spent my time praying in the chapel while my daughter was in surgery.  I'm an agnostic, so this is unusual behavior for me.  Finally the surgeon called me on my cell phone.  So with great trepidation I walked to the doorway of my kid's recovery room.  OMG you'd think she never had surgery!  She was talking and laughing with her nurse, was able to walk to the bathroom unassisted (you have to before they let you out) and in general she was bright and chipper. It was UNBELIEVABLE. Seriously like a miracle.  I am not exaggerating at all.  It was like nothing ever happened.

So what did the anesthesiologist and I agree upon?  Not GA.  Not Versed.  Not a dangerous regional block. (interscalene)  Propofol.  Nothing but Propofol.  Now the kidlet's clavicle is in place with a plate and a bunch of screws and she is back competing on her horse.  The one that fell down with her and broke her collar bone in the first place.  (Another story.) She won the novice division at a schooling event a few weeks later.

Do not be afraid.  If I can do this, get control of medical treatment, so can you.