Other Blogs and Pages

Here is a link to a person who was grievously injured by medical care.  One of those who suffered the iatrogenic disasters that I speak of from time to time.  He also goes into "informed" consent, or the lack thereof, another of my pet peeves.  Happy reading, if you can call it that.

Click here: Cameras in operating rooms : Ghost Surgeries the common deception

Or if the link doesn't work, www.shellyskalicky.blogspot.com

Here is Pro-Publica's facebook page where you can share your story and talk about many different facets of medical care in today's world.

 3) ProPublica Patient Harm Community

Don't forget author Elizabeth Bewley.  I have her books and I love them.  They are easy to read and are must haves for navigating the hostile medical field.  I can't encourage you enough to buy her books.  

Click here: Elizabeth Bewley

Knee Replacement, Versed, and an Enlightened CRNA

My husband had to have a complete knee replacement recently.  He had injured it many years ago and finally it gave out.  That meant surgery.  Surgery that includes the dreaded SEDATION!  Sedation as defined by the medical field, not by normal people.  Naturally I freaked out!  My husband didn't want to remember the surgery and *I* was adamant that he not get Versed.  I reminded him of what he went through after my unqualified DISASTER of an experience with this drug.

I called the surgeon's office and requested an anesthesiologist that I personally have met.  How odd is it that patients can request which surgeon they want, but not the anesthesiologist?  I did not get the anesthesiologist *I* wanted.  My husband was nervous enough without me having one of my tantrums, so I let that one go.  The doctor was from the same group as the one I wanted and I'm pretty sure that she wouldn't have sent a bad one.  (I know this doctor peripherally through horses, so once again horses saved the day)  So we got an anesthesiologist whom we had never met and then got a crna.  I was getting anxious...and *I* wasn't even having surgery!  I just couldn't imagine caring for somebody as out of control as I was after my ORIF.  What if my husband responded like I did?  No way I could take care of him.

The anesthesiologist explained that the crna was NOT all on her own like Aaron, my crna was.  He told us how he would be doing the nerve block and that as soon as my husband was stable and comfortable with Propofol, he would turn the Propofol drip over to the crna.  He stressed that he would be immediately available if a problem arose and that he NEVER left his crna's on their own without oversight, like Aaron was.  He stated that he had no problem taking over from the crna at any time and that he tended to be possessive over his patients.  The crna did not seem in any way annoyed about any of this.  If you have read this blog you know that a lot of crna's have as much disdain for doctors as they do for patients.  This was NOT the case where my husband went.  Our crna was part of the team, not God incarnate.  I know that the two of them saw the glint in my eyes and they were very good about allaying my fears.

The crna is the person I want to talk about.  She was very kind.  When we said "NO VERSED" she was absolutely fine with it.  No argument.  She stated that she herself had been given Versed (she believed the lies?) and had a very bad experience with it.  She stated that she experienced partial amnesia for more than two weeks afterwards.  She had fuzzy mental processes.  Do we want mental agility in our crna's?  Yes.  Do we want the crna's to decide that our own mental processes are not as important as theirs?  No.  Do we want crna's that are so desperate to make their own job easier that they will use a bad drug for that sole purpose?  No.  I'm amazed that we got a crna who was sane.  I've had so many crna's come here and "attack" me for stating the obvious about Versed that it was SHOCKING to get one that absolutely agreed with me.  She not only agreed that Versed was bad, but she kept her promise not to use it.

Apparently we are making progress with crna's.  At least where *I* am at.  It helps that she had firsthand experience with the nasty Versed and hated it.  I still don't get why she allowed it in the first place, but at least it was a learning curve which she extrapolated from and applied to her own patients.  What a great nurse!  SHE didn't decide that Versed was bad for an exalted personage such as herself but just fine for everybody else.  I still can't believe it.

I just wanted to publicly praise one particular crna and the professional way she dealt with me.  (my husband is the opposite of confrontational)  She realized that *I* was an important part of the team as well.  I will allow this woman to be part of any team I may have in the future.  I still want my friend the anesthesiologist, not a substitute, but the crna will be welcomed by me.  The rest of the crna's like Aaron who tried to destroy my life by assaulting me with drugs I had declined and all of them who have posted their rants here, there and everywhere are still on my sh*t list.

There is hope for all of us who have had bad experiences with Versed.  For myself, I would have gone with the nerve block and zero sedation, but for those like my husband who are stressed out by the very idea of monitoring their own surgery, you can get what you need without Versed.

Anesthesia in the Dental Office

A reader sent this to me and I have reproduced it here with his/her permission.
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Today, at age 47, I had all four of my wisdom teeth extracted. The top two were fully erupted, the bottom right one was a partial bony impact and the bottom left one was a full bony impact. By my request, I was given a local anesthetic only, the procedure took about an hour, and was entirely painless. I was able to drive myself to and from the appointment, and treated myself to a movie on my way home before the anesthetic wore off.

From everything I've read or have been told, it is very rare in the United States to have impacted wisdom teeth removed with only a local anesthetic. Apparently, the standard of care is to provide IV sedation (usually Versed) for a procedure that is absolutely painless if the local anesthetic is administered properly. Before finding the dental surgeon who performed the extractions today, I was told by a nurse at a different dental surgeon's office that IV sedation is "better for everyone involved" when impacted teeth are removed. Of course it's better for the provider when an extra $400-$500 can be tacked onto the bill and the patient won't remember a damned thing about what was done, and the patient can't object to his treatment because he "lacks capacity" under sedation. What arrogance to assume sedation is always "best" for the patient! Unless the patient states a desire to not remember the procedure or is so anxious that the procedure can't be done any other way, there is absolutely NO benefit to the patient.

It wouldn't be so upsetting if this was an isolated comment by a very callous nurse. About three weeks ago, I had my teeth cleaned at a clinic at a technical college. At that point, I knew I was going to have my wisdom teeth removed, and informed the hygienist who was supervising the student working on me. She made some comment about making sure I had someone to drive me home and being careful until the sedative wore off, and I told her that I had absolutely no intention of being sedated. The hygienist replied that the pain would be too great for a local anesthetic, and that I would need to have IV sedation. When I told her I knew what Versed was, that it does absolutely nothing to block pain, and that I already scheduled the surgery without sedation, she stared at me wide-eyed and open-mouthed. She mumbled something about the "dental surgeon knowing what was best," and I left. I was so bothered by her comment that I called her the next morning to ask why she lied to me. She completely denied lying about Versed, and said she had told me only that my surgeon would know whether or not the pain could be controlled by a local anesthetic.

When I first read this blog about 6 months ago, I thought many of the entries were over-the-top in painting a picture of a conspiracy among medical and dental providers about dissembling the true purpose and use of Versed. From my own experience with an endoscopy clinic earlier this year and having my wisdom teeth removed today, I convinced that there is at least a culture, if not a conspiracy, around this drug. There is a big difference between being told "this drug will help you relax" and "this drug will cause you to not remember anything that happens to you, although you will be awake." If more patients understood what they were being given, and why, more would refuse Versed. I suppose that some providers can justify the lie if they believe that a number of patients might forgo important procedures if they became anxious about the notion of being given a drug that would allow them to be awake, yet rob them of their memory. And it may be true that some patients would not be treated, it is not up to a provider, or up to ANYONE, to decide what is right for a patient, except the patient!

I've also learned that there ARE providers who will work with you and respect your wishes about not being administered Versed (or Propofol, or other amnestics.) If this is what you want, just be firm and state your intentions clearly. Someone who thinks they know what's best for you, regardless of your wishes, is probably not someone you want providing your care. Be patient, and find the right provider. He or she is out there!

Like Good Political Songs?

The Avett Brothers - Head Full of Doubt/Road Full of Promise (Official Video) - YouTube

EMT's Unauthorized Use of Versed/Midazolam

EMT's use the "sedative" (amnesia and obedience drug ONLY) Versed/Midazolam to make their jobs easier too.  I include them in my "medical personnel" description, but some may not think of EMT's using Versed.  They appear to love it as much as the minions in hospitals and surgical suites do.  A friend of mine sent me this article:

Click here: 3 Texas medics suspended over drug administration

Pay special attention to the posts below the article.  They are ALL in favor of using the brain poison and without authorization from a person who has an MD behind their name.  They feel it its their RIGHT to inject Versed into anybody and everybody without MEDICAL DOCTORS permission.  The EMT's don't like it when a real doctor interferes with their plan of action.  The EMT's want us to know that Versed/Midazolam is "safe".  People don't DIE from getting shot up with Versed!  Of course not.  The EMT's did nothing wrong and didn't deserve to be disciplined.  Benzos are 100% safe, too bad for the dead people but it wasn't the Versed.  All kinds of excuses.

 Note; The article takes great pains to say that it wasn't the Versed that killed these people, that the EMT's were merely punished for using Versed without authorization.  If Versed was so risk free than why would the EMT's need authorization in the first place?  Why would the doctor(s) be upset with the EMT's for using the drug on the patients who later died, if they didn't believe that Versed/Midazolam wasn't inextricably tied to the deaths?  It makes no sense.

 Something about this drug makes normal (?) people write rabid responses to anybody who dares criticize its use  The author of the news report is wrong, sensationalizing etc.  Versed is good and necessary and they WILL use it. The EMT's don't care if a doctor authorizes its use or tells them not to use it.  Easy enough to fail to report what they are doing isn't it?  Except for this particular case where the EMT's were called on the carpet for using Versed without permission.  (and without a second thought as to the safety of the patients they were "caring" for.)

Here's Your Obamacare

Obamacare aka "The Patient Predation and Unaffordable Care Act" is a disaster.  We have all seen little Jonny Gruber prancing around, telling us we are all stupid and detailing what the real deal on Obamacare is.  Like I and others who read the atrocity already knew, the law was passed on Christmas Eve when congress was not in session to conceal from the public what was in it.  The entire bill was nothing but a power/money grab by a duplicitous government in order to bail out the medical care/insurance industry and extract more taxes from a hapless public.  But don't trust me, after all *I* am one of the American public that Jonny boy claims is stupid.  Here is an essay from a doctor whom I follow on his blog here; In My Humble Opinion
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Tuesday, November 18, 2014

The Not So Humorous Unintended Consequence of Healthcare Reform is Monopoly

Check

The administrator's voice wavered as I picked up the phone.  He was calling about the nursing home patient that I admitted the day before.  While normally forthright, I could feel the discomfort in his tone as he danced around the issue.  The patient's insurer had called.  Apparently they made an "arrangement" with the Mega ACO owned by the latest consolidation of Goliath health systems.  They wanted my patient transferred to another doctor.  Apparently the insurer now required all it's patients to be seen by only medical group physicians.

The administrator was almost whispering now.

The truth is, if it was up to me, I would have you see all our patient's!

The medical group doctor hardly ever rounded.  She was almost never available for urgent calls.  Her patients were transferred out to the hospital at the drop of a hat.  Yet, incredibly, she was managing three quarters of the nursing home population.   But the medical group physician had one advantage that trumped clinical quality or even cost of care.  She was measurable.  Her every move was recorded in an electronic medical system that could be beamed into the greedy hands of administrators, case managers, and insurers at whim.  This data could be analyzed and assessed, and spit back at her with ultimatums and extracted promises.

We sat silently on the phone at a loss for words.  The nursing home could not dare damage the fickle relationship with the ACO.  Otherwise the growing stream of patients coming from the local hospital would diminish.  It had been that way for some time now.  The threat was implicit to the arrangement.  The not so humorous unintended consequence of healthcare reform is monopoly.  And there is a power grab by huge expansive hospital systems for the billions of dollars, I mean patients, ripe for the picking. Physicians and nursing homes, doctors and nurses have all become pawns.  They are fodder for a game playing out around the country.

The administrator was the first to speak.

You know that the ACO will be merging with your other hospital systems soon.

He was right.  It was only a matter of time before they would be kicking me out of the nursing home business and replacing me with some no named company man.  As I began to hang up I sensed a ring of optimism bouncing over the phone line into my unwilling ear.

You might want to join the medical group, we really need you to see more patients here.

I hung up.

Check...mate.

ANOTHER Amnesia Drug

A reader sent me this link.

 Anesthesia-related memory loss lasts days, study warns

This one is about yet another Versed style drug which causes AMNESIA.  The description of the effects of the drug are exactly like the description of Versed.  Amnestic, hypnotic, sedative used for CONSCIOUS SEDATION and ANESTHESIA INDUCTION.  Sound familiar?  The study needs to say that PRE-ANESTHESIA DRUGS and SEDATIVE DRUGS used as an adjunct to anesthesia are the culprit for continued memory loss.  Well duh, disrupt the delicate process of memory retention with a powerful drug and then be astonished when the memory loss that THEY WANTED AND CAUSED continues.  What the Hell?  Cause amnesia deliberately and then be all shocked like when it persists?  Are these people really smarter than the rest of us?

Oh yes, this Etomidate is a "good" drug except for the long term memory loss. Who cares that the patient is in a nursing home with Alzheimer's afterward?  The patient is out of their hair by then.  Good job medical people.

If you don't want your brain destroyed by the medical field decline ANY kind of sedation.