A more interesting question in my opinion is, "Why operate on any of them at all ... even once ... black or white?"
Posted on 01/02/2016 7:14:53 AM PST by Zakeet
Heroin addicts with recurring heart valve problems caused by their use of dirty needles are forcing surgeons across the state to make difficult ethics decisions on continuing to provide them expensive care.
Cardiac surgeons are seeing a 50 percent increase in ineffective valvular heart disorders attributed to the use of dirty needles, said Scott H. Bronleewe, a cardiac surgeon practicing in Tampa for the past 26 years.
The cost is staggering: more than $500,000 for the procedure and hospital stay for an uninsured addict, many of whom are back on the operating table within a few months, suffering from the same infections.
Surgeons across the state, already stretched thin by the problem, are stepping back, saying they will operate on an addict once, maybe twice, but will draw the line at a third time.
(Excerpt) Read more at tbo.com ...
A more interesting question in my opinion is, "Why operate on any of them at all ... even once ... black or white?"
$500,000 of government money to save the life of someone who shoots heroin regularly? That does not sound like good public policy.
I can’t help but think that over-regulation of opiate pain medication has helped the rise in heroin use.
Yep, drugs are like a water balloon, squeeze in one place and it bulges out in another.
Also, with the release of more drug dealers by this administration it will be getting worse! The problem is that those that are using the drug are people that started out with a lesser drug! Fact! Worked in the prison system and they would talk about it!
Why is the over-the-counter sale of hypodermic needles illegal? It makes life more difficult for diabetics and other people that require injectable medicine.
The ban was put in place to protect drug abusers from themselves. And now it apparently just makes things worse for them as well.
Government paternalism in action.
... As arm operation day approaches I get a visit from a nurse who leaves several clear plastic bags of blood-thinner and several needles. I am instructed to start using the stuff two days before the operation. The intent is to help prevent the formation of blood clots during and after surgery, something which killed my father 40 years earlier. At this point the sight of an IV needle makes me sick to my stomach and being reminded of my father’s early death fills me with a sense of great loss, but the nurse expertly inserts the IV into my arm, secures it with tape, and installs a little sealed spigot on the end. As she leaves the nurse cautions be about cutting myself because the thinner will prevent normal clotting. Swell. The next day I take a deep breath, strap-on the first of the bags, and connect the bag’s tubing to the spigot. Butterflies form in my gut. I’m going back to the hospital and I’m going to be cut some more. The next two days pass lowly and miserably despite Martha’s attempt to keep my more cheerful.
Operation Day. I arrive at the hospital again and it is depressing. I felt great leaving it for rehab but now I am going back inside although on my feet rather than flat on my back. I am using my cane now so I am able to go up to preop with little difficulty. I hang my cane and clothes on a coat hook in the little undressing cubicle and then lie down on another damn gurney and wait. Martha stands by my side and we make small talk as I fight the icy lump in my stomach. After an hour an orderly appears and it’s show time. I am wheeled along a maze of passageways, in and out of elevators, and emerge in an operating room. It is awful. I don’t remember my previous surgeries because I was either unconscious or delirious. Not this time. “On three†says someone and I feel hands grip the sheet I am lying on and transferred to the operating table. The room is cold and reeks of medicinal smells. The table is hard and ice-cold on my back . The walls are tile and the room garishly bright under multiple lamps with the biggest one right over the table and carrying about half a dozen bulbs. There is a small boom box on a shelf playing light music. Half a dozen people masked and gowned and gloved stand about looking at me and at various monitors. The surgery looks like a Borg set from “Star Trek†– all too bright lighting and metal. One masked person (man? woman?) talks softly as various electric leads are taped to me. Another says, “OK, here comes the anesthetic†as (he/she) skillfully inserts the needle into my right arm. Then silence, cold, harsh smells, electronic beeps and boops, suppressed panic. Minutes pass. The people bustle about not paying me much attention. My back is really cold and I am about to jump out of my skin, so I sit up, my arms across my knees. More minutes pass. I try to make small talk but the staff is busy. Finally someone else comes in (the surgeon?), looks at me, and says, “Isn’t he out yet?†(Duh.) I am told to lie down again and someone does something out of view. “OK, Mr. Berlander. Count backwards from 100.†100…99…98…97…gone…
Cold. Harsh light, even with my eyes closed. Medicine smells. Sounds. Pain! Bright, blinding pain like nothing I’ve ever felt before. My left arm is on fire and is being ripped-off. I open my eyes and see an eyeglassless, out-of focus large room, brightly lit. The pain is monstrous, worse than anything I’ve ever imagined. I hear myself screaming, a strange sound, somehow both close and distant. My arm is being chewed-off by a wild animal. I can see many gurneys, most empty, to both sides of me. I keep screaming from the pain, then start yelling. “Help! Help me! Someone help me!†No one comes, just more pain so intense I want to vomit but can only retch from having fasted before the operation. I’ll do anything to stop the pain. I roll my head to the left and see my arm encased in huge bandages all taped to a large flat board. The pain! “Help me!†I scream. “Someone help me!†The pain is tearing me open from the inside with bright, sharp talons. I expect to see my guts leap from my body. I am blinded by tears of pain and fear and anger. I whip my head back and forth as if somehow motion will help with the pain. It doesn’t. I have to get away from the pain, somehow.
“Help!†Then, a female voice. “I’ll be there in a minute. Stay calm.†Calm!? Is she shitting me??
I lie there in agony, rolling my head about and thrashing my feet, anything to get away from the pain. The pain goes right through me like an incandescent spear, leaving no part of me undamaged. I try to remember the lessons from Navy SERE School about distracting yourself while under torture but nothing seems to work. Just unbelievable pain and no one helping.
After an indeterminate time someone arrives at my gurney and asks me how I am. I can barely speak, my throat choked with bile from the pain. My gurney starts moving and I find myself moving through a haze of pain through more passageways and up to a room. I will have to spend the next several days in the hospital before I can again go home. But the only thing important now is getting away from the pain. We arrive in my room and I am once again transferred to a bed. I barely notice it so all-consuming is the pain. My IV is connected to a bag on a stand and I find myself drifting off. Must be pain meds…thank God…
I’m back, awake again. The pain has lessened a bit. It feels like my arm has simply been barbequed and then driven-over by a small truck.
“Take this,†says a voice. I turn my head to the right and there is a nurse holding two small paper cups. One contains water and the other two tablets. “It’s Percocet, for the pain,†she says. I reach for them eagerly and put them in my mouth, then drink them down with the water. My bed is next to the window and it’s a bright, cold spring day outside. Small cumulus clouds scoot by against a deep blue sky, driven by a strong wind. The Sun is shining. The pain is still a garishly colored wild animal, glaring at me from across the room, teeth bared, ready to pounce.
“The doctor said I could have a morphine pump for the pain,†I say with a whine in my voice I immediately hate. How pain can twist everything in your life.
“I’m afraid we have only one on this service and your roommate has it,†the nurse says with a hint of apology.
My roommate?
I turn my head to the right and there is a youngish guy in the other bed. He looks like a bum. His long, filthy, black hair tumbles over his pillow. He is thin, sallow, unshaven, mean-looking, with small, dark eyes that dart about the room apparently defending against something. His thin body is outlined in the sheet that covers him. He has small scars on his face and neck.
“He’s here for drug detox again,†says the nurse, still apologetic.
’And he has MY morphine pump??’ I want to scream but somehow hold my tongue. My roommate is every nasty stereotype of the loser druggie who demands what he wants while giving back nothing other than hatred.
Just as I am falling off to sleep a wheelchair arrives and I am taken down to Radiology. This is just as my last Percocets are wearing off, I realize with a jolt of panic. I am parked just outside Radiology and abandoned. The pain comes back, horrible and tearing. I start to cry with it. A doctor then appears and introduces himself and tells me he is going to “administer ionizing radiation to my injured elbow.†It seems that without this treatment there is a 30-40% chance that my elbow will recalcify and freeze again, a chance I am unwilling to take. With the dose of radiation the chance of my elbow refreezing is reduced to 5% but the chance of developing bone cancer somewhere down the road is 1-2%. “Let’s make a deal.†I choose Door # 2.
I again have to wait for a technician because it is 5:30 on a Friday afternoon and all of them have gone home. Tears of pain roll down my cheeks as minutes pass like hours and I desperately try to hold my left arm – which is taped to a board -- at just the right level to slightly diminish the pain.
[Digression: The plain fact is that I have to give the hospital high marks in everything except pain relief. That earns them a big, fat “F.†From the surgeon who crunched the external fixator screws from my arm bones while blood spurted out of the holes and I yelled in pain and he didn’t give a shit, to my awakening from this recent surgery in agony, to this current episode in Radiology, doctors just don’t care how much pain a patient is in. It is the nurses, orderlies, and lowly PCAs who do care and do what they can around the physicians’ disinterest. Why medical schools train doctors like this is unforgiveable and baffling. Doctors need to get a taste of their own bitter medicine.]
Finally, the doctor reappears, announces that “For the radiation to work, it must be administered within 24-48 hours after the surgery†and that “The principles of medicine don’t change just because it’s 5:30 on a Friday,†and wheels me into the chamber. I have to hold my arm at an agonizing high level and he tells me not to move until he comes back. He leaves and a short time later I hear a soft buzzing coming from the magnetron and realize the radiation is on. What seems like an hour passes as I hold my arm high, bite my lip until it bleeds, and cry. The doctor finally reappears and tells me the treatment is over. I feel like throwing-up from the pain and am about to pass out. He leaves me in the hallway and soon an orderly comes and wheels me back to my room. He helps me out of the chair and I half fall into bed, finally able to lay my arm down softly (at heart level) on the cool blanket. Heaven. But not for long.
For the next two days I am trapped in the same room with my raging druggie roommate, a miserable excuse for a human being who screams 24 hours a day at the staff. “I want more morphine, you f****** assholes!†“I’m leaving now unless you give me what I want!†“You f****** bitch! Get over here!†“I’m leaving! I’m calling Social Services! You can’t treat me like this!†“I need MORE drugs!†*brief episode of sobbing and self-pity* then “You’re treatment SUCKS!†“You bastards! They give me better than this at the free clinic!†(like he’s paying for this hospital stay) “I’m calling my counselman!†All this delivered non-stop in a sob-punctuated shriek while storming around the room with the morphine pump on a little trolley, following him around like a small dog on a leash running to keep up with its master. MY morphine pump. So the next two days pass horribly, a blur of my own pain and the torture this drugged-out POS is inflicting. I had never before thought much about drug addicts beyond a vague disapproval. By the end of the second day (and night) I want this one to die. Life’s like that. Get a big dose up close and you’ll be astonished how quickly your opinions change.
As the Druggie Symphony rages on in the background like a Klingon Opera gone bad, I am slowly recovering enough to get out of bed and take short walks. I can’t use my cane because I have to very carefully hold my left arm with my right hand, keeping it exactly at the level of my heart and not moving the elbow at all. The pain is still white hot but the feeling of my arm being torn off has subsided a little. Seems the surgeons had to bone saw-off my lower arm at where the elbow had been, refashion a do-it-yourself replacement, and then reattach it to my upper arm. The nerves had been squashed and there had been a lot of damage so I have little feeling in my left hand (a blessing).
One day during a shamble down the hallway I come across my arm surgeon (surgeons specialize in limbs, I’ve discovered; this is not the guy who did my right leg). I timidly hold up my swaddled left arm and with my right hand make my left elbow flex just a bit. “Look,†I say, “it moves!†He eyes me coldly and says, “You’re not even on first base yet†and then walks away. I make a life decision that orthopedic surgeons are truly the assholes of the medical community.
Finally, it’s time to leave the hospital again. Martha and my friend John show up and accompany me down the hallways and through elevators and then it’s the ride back home. Ahead of me is nearly a year of outpatient physical therapy, the civil trial of the guy who nearly killed me (the state refuses to press charges), and then months of looking for a job. I will finally begin working again 21 months after the accident. But that’s the unknown future. For now, I will have to concentrate upon physical and mental therapy and ending being a victim.
From "What I saw After the Crash"
Well, the other problem is that the government made it much harder to get Oxycontin, so the addicts have moved back to readily available Mexican heroin.
As a government, let people do what they want as long as it hurts no one else, and be fiscal conservative.
Yep...Ol uncle Sugar gotta save us from ourselves.
Interesting factoid I didn't realize till recently. The federal government is the largest holder of opium in the United States....and get this, they house it at Fort Knox.
http://community.seattletimes.nwsource.com/archive/?date=19930916&slug=1721425
People who have a death wish shouldn’t be saved from themselves.
There are more deserving people doctors should save.
If you’re a heroin junkie shooting yourself up, what happens to you is really between you and God.
Having the taxpayers subsidize your self-destructive drug habit isn’t what I would call service to medical ethics.
Don't spend a penny of my tax $ on any of them, unless you're buying a box of 22 shorts.
Send em to Cuba, “the best medical care in the world”!
Drug dealers should have one month to trial and if guilty shot the next day…
know a girl that has been on and off drug since she was twelve years old..her mother was so bad the neighbors offered to adopt her..in rehab for herion and has two little girls
If an alcoholic comes into the hospital we are required to provide him with liquor.
Addiction is a life-long problem.
Buprenorphine/naloxone prescriptions should be refillable by any doctor.
Junkieburgs could be set up by private enterprise. Junkies could work for and get their fix away from the rest of us.
I thought needles were available over-the-counter from a pharmacist.
Most operations should cost less than $20,000 - a guy with a knife and another guy with metered gas canisters and a mask work with one woman for a few hours in a clean room with a table.
Transplants should cost no more than about $50,000.
Hospitals need to be converted to REITs leasing out space at say $20/year per square foot triple net. Let doctors rent out space and set up operating rooms, ERs, and pathology labs. Let nursing unions operate recovery wards.
Watched a program some months ago that showed a fella who claimed to by dying of cancer on the streets purchasing heroin apparently because he didn't have insurance and the medication was too expensive.
Similar program, a bunch of seniors were having to take a particular heart medication I believe that cost $20 a tablet. They could not afford the medication so they found the exact same drug, twice as potent for pennies....at the feed store. It was a medication for Sheep. The seniors were purchasing the drug, cutting the tablet in half to equate to the proper human dosage....for again, pennies.
Somethings terribly wrong with our medical system. We pay the highest prices for prescription drugs than any country in the world. Our medical system is unmatched, the best in the world...if you can afford it.
The US spends $25 million a year for free needle exchange programs and these folks can’t even collect free clean needles?
(I can’t help but think that over-regulation of opiate pain medication has helped the rise in heroin use.)
We see them all the time in our center and a sad amount are recovering Vet’s spit out by the VA. Heroin is cheaper and easier to get than prescription med’s. The VA shovels them down their throat then shuts them off.
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