Tuesday, August 07, 2007

Medical Problems

Both mine and others.....

I just got back from an appointment with my doctor. My total cholesterol level went up nearly 40 points since I started new medication for it. I'm not happy, and I suspected that it would happen. My doc, God love him, is really good. He knows what he's doing, he's honest with me (as I hope he is with his other patients), and he talks to me as a peer; I'm pretty sure it's because of the business I'm in, and I believe he respects that. However, he like all other medical providers is stuck due to insurance rules regarding allowed medications in their formulary, and I am currently a victim of that. He wants me to take Vytorin, which is a combination of two other drugs, Zocor and Zetia. I've taken Zetia in the past and it was actually quite effective. The problem with both Zetia and Vytorin is that Anthem, my health insurance provider, will not pay for it. That is a problem, as the statins don't seem to be quite as effective. At one time I took Lipitor, another statin, and it worked reasonably well, except that I had trouble with side-effects. I was affected by extreme muscle pain, especially in my arms, and I couldn't do my job. So we went to Zetia, which worked but I couldn't afford. I am now taking Zocor at 80 mg/day (I was originally at 40, which is what led to the crummy numbers), and if that doesn't help we're going to petition my health insurance carrier (again) to get them to pay for the Vytorin. Personally, I suspect hell will freeze over first, but I could be wrong.....

Did the reverse-24 yesterday with a shift at the track prior to that on Sunday. It was a busy and eventful city shift; we did 7 overnight and I want to say either 4 or 5 during the day. They included people that really needed help, including a diabetic whose sugar was in the bucket at 15mg/dl and she crashed her car into the side of a panel truck. Her airbags didn't deploy and the engine company on scene was worried that they would, so we had to rapidly extricate her from the car before we could treat the hypoglycemia. Once we woke her up with a dose of Dextrose (25g in 50% solution), her first question was,"where am I?" When we told her, she got really upset and was really afraid that she'd get in trouble. Apparently this happened to her one other time and must have been told that there would be consequences.... I found out later from my partner that she had an implanted insulin pump and has been having trouble with her blood sugar levels for a while. Perhaps she should have seen her endocrinologist before it went as far as it did.....

Another that we did during the overnight was for an MVC with three people involved. We were the second ambulance; the first brought in a patient who was ejected from the rear window of the single vehicle into a tree. He had pretty massive head injuries and went to the OR not long after he was brought in. We had two patients, the driver and the front seat passenger. The passenger also went to surgery for removal of debris from his right arm; I don't know what happened, but I'm led to believe he put it through the passenger side window. The driver was also transported, but he didn't have significant injuries; he ended up in jail.

Tonight I am working in Goffstown - hopefully it will be reasonably uneventful, but I am not optimistic. My friends all tell me that lately I have been a "black cloud" - in other words I attract bad calls. They all say it in jest; it is part of the dark humor that many EMS professionals possess. Sometimes you have to have that because if you let the really awful calls and situations get to you it can really hamper your ability to be effective on the street. One of the things that I've learned to remember - and I know this will sound somewhat mean-spirited, but it has to be this way for me to function - is that when I respond to an emergency, I responding to someone else's emergency, not my own. That really does help; I'm still able to be effective and compassionate, but I'm staying detached from the situation. With that said, it doesn't mean I'm not affected by what I see; many times I am. However, if you allow yourself to climb into the same basket that your patient is in, then you can't do your job. It's that simple, and I don't know of any other way to say that.

In other news, from today's Union Leader: the President of France is currently vacationing up on Lake Winnepesaukee, and when reporters pointed cameras at him, he went nuts. Do you blame him? Now the press is making a big deal out of his political opponents' questioning who paid for the vacation and how he could justify taking it.

Regardless of how most Americans feel about the French these days, the guy is on vacation, for cryin' out loud! Everyone deserves a break now and again, even the President of France. Personally, I could give a rat's ass who paid for it.... Why can't they just leave the guy alone for a little bit? If it were George W. Bush vacationing somewhere and the media were to do what they did to him as they did to Nicolas Sarkozy and Bush responded the way Sarkozy did, the media would ape him like crazy. What is happening with Sarkozy is nothing compared to what would happen to W. My opinion, of course, but this is just a stupid thing. The media should just let him be so that he can enjoy what's left of his vacation.

1 comment:

NH Mind said...

It's outrageous that Anthem won't authorize/cover the use of Vytorin...It's extremely effective in my case and as a combo, it offers the best of both. I'm always amazed at the seemingly arbitrary way in which health plans approve certain drugs..it's all about the cost to them. We've had HCHP for years and on rare occasions have had to challenge them - hopefully you and your doc can mount an effective challenge to Anthem's ridiculous exclusion.
As far as the young guy that went through the rear window, I heard he died...that was a nasty accident.
I gotta believe the US press is far more forgiving than the crazy European press...they ought to just leave him alone and let him enjoy Cow Hampshire for a couple of weeks....who knows, perhaps we'll become the summer vacation capitol for all of the world's leaders.