Recovering from surgery

Tomorrow, I go back to work. It has been five weeks of lots of pain, drugs, a drained bank account and strained relations with those close to me.

Hospital was horrible. It’s easy to forget how much pain a surgery creates. Also, due to drugs administered for my first surgery six years ago that left me unable to move/feel anything below my waist for over two days after the resection, this time they went soft on the drugs.

My surgeon and pain team were in constant war over what to give me. In the meantime, I was left spewing bile from both ends, which woke me up requiring new bed linen and pyjamas during the night. I was feeling so bad that it was hard to have any kind of conventional shame. Not that I wanted that…

Anyway, my pain team eventually got me some stronger drugs, which slowed my ongoing problems and I was able to get out of the hospital by the end of the week. By that time, my sleeping patterns had got even worse with the bright lights and annoying sounds that are standard in a hospital.

Over the last few weeks, I have been at home recovering from my resection and things have been pretty tough. I still get a fair bit of pain and achy bones that prevent me from helping around the house or doing much at all.

All in all it has been pretty depressing and an extra strain on my life as a whole.

Tomorrow, I end my time as a night owl and will work three days a week during normal business hours. I hope it will help but I can’t help but feel nervous about it all.

While I still have some pain, I can’t help but think about the time this disease has taken from me. The activities I couldn’t partake in and the precious minutes turned into hours explaining why I feel the way I do to an often underwhelmed audience.

But in the face of tomorrow, I can only wish for better days ahead because the hospital bed is now a place I’m wanting to avoid at all costs.

The impossible dream

I can’t believe it’s almost here. Tomorrow, I will enter the surgery room and recieve my second bowel resection. It has been just over five years since my previous (and first) one. The thought of having another surgery has brought to the surface all kinds of emotions within me.

For example, the other night I had a strange dream/nightmare. With all the drugs I’m taking, I have started to have dreams (and nightmares) again. In this dream, I was in a hospital ward and was being asked for money for my treatment. But no matter how much I gave it wasn’t enough for the doctors, nurses and my parents who surrounded me.

I started to get angry at their insistence that I pay more. I told them I expected more from public health. This was the first world, I told them, and asking someone to pay was against my principles of social justice.

But rather than take my advice, the surrounding staff laughed at me and asked why I expected so much. They said the government was perfect and to expect any more was crazy. They give us so much already, they said. Do you like paying high taxes, they continued.

Soon after this, I was awoken by my partner getting ready for work. It was all a nightmare, or was it?

Over the last year, I have receieved my fair share of not only underresourced heath care, but also staff whose pessimism towards the situation had hit rock bottom. Some of these people decided to turn the blame towards me because anyone that opposes an injust system must be mentally unsound. Surely?

On top of this, our Liberal state government has further cut back services (see previous post) leaving the substandard status quo as a distant dream for healthcare activists.

As I go into hospital this time, I have my fingers crossed that everything goes smoothly. After the extra long wait time and subpar service endured by anyone not considered to be “dying” it’s the least we deserve.

Victorian public hospital funding slashed again…

Interesting article that gives context to my hospital troubles by public health advocate Kylie Moon in the latest issue of progressive newspaper Green Left Weekly.

Cuts to the Victorian health budget are having a significant impact on Victorian hospitals.

More than 300 beds have been closed, elective surgeries have been delayed, and jobs are being lost as hospitals attempt to implement a funding cut of $107 million by June this year.

While large-scale redundancies are yet to be announced, many nurses who rely on casual work as their sole income have been impacted as hospitals scramble to save costs by cutting casual staff. The Australian Nursing Federation (ANF) Victorian branch said that “redundancy by stealth” was taking place with many vacant positions being left unfilled, nurses who recently completed a graduate year not being offered ongoing positions, and many recently graduated nurses cannot find a position to start their careers.

Rural communities are feeling the impact of the cuts. Beds have been closed in rural hospitals and as a result people in these areas are being put at risk. The urgent care centre at Colac, which used to operate between 10pm and 7am, has been closed and patients requiring emergency treatment will now have to be travel 75km to the nearest major hospital in Geelong.

The Angliss hospital’s emergency department in Ferntree Gully is under threat of being closed from 9pm to 9am.

The Victorian community and hospital staff are suffering at the hands of a dispute between the federal Labor government and state Liberal government over funding.

Federal health funding to Victoria has been reduced by $475 million over the next four years based on new population data. Meanwhile the federal government is claiming that they have increased the Victorian allocation of federal funding by $900 million over the next four years as part of the Health Reform package.

The ANF has written to the state and federal Auditor Generals asking them to help resolve this dispute. The $107 million funding cut to be implemented by June this year comes in addition to the $616 million the state government has already cut from the health budget over the past two years.

Meanwhile, despite the severe budget cuts faced by public hospitals the state government has provided $4 million to private hospitals — under a scheme to enable public patients waiting for elective surgeries to be operated on in private hospitals.

The Peter MacCallum Cancer Centre announced the closure of 16 beds on February 22, which will put significant pressure on the hospital to have earlier discharges, fewer admissions, and treat patients in their own homes.

The ANF are likening this round of funding cuts to the what was experienced under the state Liberal Kennett government in the late 1990s when 3000 nursing and midwifery jobs were lost and 400 beds closed across Victoria.

Today only the sickest patients are admitted and they are discharged as early as possible, as the trend in health care has been to treat patients in their own homes or in the community. Given this shift in health care delivery and the already existing climate of bed shortages where there is a constant push for more beds, any bed closures will be putting a huge amount of pressure on hospitals not to admit acutely unwell patients or to implement earlier discharges. Patients will be left to languish in emergency rooms or their own homes, treatments will be delayed and the sickest people in our communities will suffer.

Happy New Year?

Wow, so here we are. A new year, marking around 12 months since my Crohn’s Disease started to flare up again in a real way. It was, to say the least, a shock to the system for someone who had, for the past few years after my surgery, been able to regain normalcy in my life, finish my undergraduate degree, have several jobs, be published in various publications and met the woman of my dreams who I have now spent the past four years with.

When doctors ask me how my current disease infestation compares to when I had my last surgery five years ago I say that without a doubt this time it has been far worse. To add insult to injury I’ve been met with a health system in which its casual attempts to give a crap are confronted with impossibly long waiting lists for surgery and further cutbacks from both Federal Labor and State Liberal governments. All I’ve been hearing for months are excuses about the limited nature of my small bowel, which while true is necessary when it’s obvious to everybody that no treatment has stopped the flare and only heavy painkillers have given me temporary relief. It’s a joke that’s impossible to laugh at. It’s a failure that is consensual amongst Australia’s two parties of Established Power.

At the moment I am on booked in to finally reach the surgeon’s table in Ballarat in early February. It has already messed up the start of my year. With my post-graduate studies set to commence in March, I’m hoping I will be well enough to start.

I have also run into trouble at work where my attempts to better manage my disease by cutting to a more manageable three day schedule have met deaf ears by managers seemingly unaware of their obligations under anti-discrimination law. I just hope that my trade union will be able to plead my case because the way I have been treated so far has only added to my stress levels.

My one wish for the rest of the year is that I won’t be pushed back in the queue again by the floods of “more important” procedures, get my surgery and recover quickly. At the moment it is the only wish keeping my above water. Let’s hope that dreams aren’t just granted on a yearly basis.

US public servant reprimanded for a fart

Wondering if there is any precedent for the following. Thanks to the Smoking Gun.

A federal employee was formally reprimanded this month for excessive workplace flatulence, a sanction that was delivered to him in a five-page letter that actually included a log of representative dates and times when he was recorded “releasing the awful and unpleasant odor” in his Baltimore office.

In a December 10 letter accusing him of “conduct unbecoming a federal officer,” the Social Security Administration employee was informed that his “uncontrollable flatulence” had created an “intolerable” and “hostile” environment for coworkers, several of whom have lodged complaints with supervisors.

The worker, a 38-year-old Maryland resident, reportedly provided evidence that he suffered from “some medical conditions” that, at times, caused him to be unable to work full days. But a SSA manager noted in the reprimand letter that, “nothing that you have submitted has indicated that you would have uncontrollable flatulence. It is my belief that you can control this condition.”

A redacted copy of the letter was recently circulated among officers of the American Federation of Government Employees (AFGE), the union that represents the SSA worker. Contacted today at his office, the employee said, “I can’t talk to you about this, I’m sorry.” The employee is being represented in connection with the reprimand by a lawyer for his union, AFGE Local 1923. Cynthia Ennis, president of the Baltimore-based local, did not respond to e-mail and phone messages about the matter.

The SSA worker is pictured with his wife in the above photo, which apparently was taken at an amusement park (yes, he is standing at the left shoulder of someone dressed as Pepe Le Pew). The employee is a claims authorizer at the SSA center that handles disability cases for the entire country.

According to the letter of reprimand–which is the least severe administrative sanction that can be levied against a federal worker–the man was first spoken to about his flatulence during a May 18 “performance discussion” with his supervisor. He was informed that fellow employees had complained about his flatulence, and that it was “the reason none of them were willing to assist you with your work.” The supervisor referred the employee to a SSA unit for “assistance with what could have been a medical problem that was affecting everyone in the module.”

Two months later, on July 17, a second SSA manager spoke with the man “in regards of your releasing of bodily gas in the module during work hours.” The manager asked the employee if he could “make it to the restroom before releasing the awful and unpleasant odor.” She also recounted what appeared to be a prior conversation during which the worker suggested that he would “turn your fan on when it happens.” The manager recalled advising him that, “turning on the fan would cause the smell to spread and worsen the air quality in the module.”

On August 14, a third administrator–a SSA “Deputy Division Director”–spoke with the worker about his “continuous releasing of your bodily gas and the terrible smell that comes with the gas.” The manager noted that the worker had said he was lactose intolerant and planned to purchase Gas-X, an over-the-counter remedy. The manager informed the employee that he “could not pass gas indefinitely and continue to disrupt the work place.”

Despite these repeated warnings, the man apparently continued to struggle with his flatulence throughout the late-summer and fall.

After stating that, “It is my belief that you can control this condition,” the author of the reprimand letter then noted, “The following dates show the time of your flatulence.” What followed was a log listing 17 separate dates (and 60 specific times) on which the employee passed gas. For example, the man’s September 19 output included nine instances of flatulence, beginning at 9:45 AM and concluding at 4:30 PM.

The man was also accused of launching a trio of attacks on September 11.

The reprimand letter does not reveal how the worker’s flatulence was memorialized, nor whether that unfortunate task fell to labor or management.

The letter’s author wrote that the employee’s conduct had been “discourteous, disrespectful, and entirely inappropriate,” and was worthy of a formal sanction, which is placed in a worker’s personnel files for up to one year. The reprimand, the manager noted, “is the least severe penalty available to impress upon you the seriousness of your actions and is necessary to deter future misconduct.”

Drug companies to reveal their money trail

Australia’s Big Pharma industry will start to report what they pay doctors for consultancies and sponsorships under new legislation.

The new Medicines Australia’s Code of Conduct for the pharmaceutical industry that took effect on January 11, will include the reporting of the payments which have remained undisclosed in the past.

The change will mean pharmaceutical companies including Pfizer, Glaxo- SmithKline and Bayer Australia will report aggregate payments to doctors and other healthcare professionals for their advice.

It comes after the Australian Competition and Consumer Commission accepted the new code of conduct earlier this month.

But while the ACCC was pushing for full disclosure of the payments, industry body Medicines Australia said only “aggregate payments” would be reported not every individual payment.

Sponsorships of consumer organisations and for doctors to speak at medical conferences and educational events will also be included.

Medicines Australia chief executive Dr Brendan Shaw said every member of the industry body had signed on to improve transparency.

“Engagement with doctors is important and legitimate because patients want to be sure that their doctors know how to use the medicines they’re being prescribed.

“Now the nature of that engagement will be much more transparent.”

The ACCC approved the code of conduct for two years, on condition that it be reviewed and revised, including stronger transparent reporting of payments, before the end of 2014.

“Improving transparency around payments to individual doctors will play an important role in promoting community confidence in the integrity of these payments to healthcare professionals,” ACCC Commissioner Sarah Court said.

A number of pharmaceutical companies in the United States are already publishing details of individual payments made to healthcare professionals. In order to ensure that the code is amended in a timely manner, the ACCC has granted authorisation for two years rather than the five years sought by Medicines Australia.

Merry Christmas, festive pets!

This meme reminded me of how important animals were in the lives of people with chronic illnesses. This has been especially true during my ongoing flare-up. Even on days when I can’t get out of bed my cat, Red, has been there to snuggle up to. Unfortunately though, when in hospital I have missed her immensely.

I have heard of hospitals that allow visits from dogs to cheer up patients. But never a cat. Maybe they think it would be too unsanitary. Sad.

It’s a pity I don’t drive because it would be great to take Red to my parents house for the holidays and taking her on the train seems like it will take too much energy and could be dangerous for the cat in such severe heat. Unfortunately, driving tests have been something that have been left in permanent delay due to my condition. Every time I get my skills up to standard my flares start breaking out.

So If I go to visit my parents this Christmas it looks like it will be without my cat. It’s a pity because I know she would love their house. So many rooms to explore. But not this year…