REALITY HAS FORCED ME TO CHANGE MY POSITION ON A VA HOSPITAL

Most VA hospitals are tied to medical schools which provide healthcare to veterans using doctors in training.  This is not acceptable.   In fact, Congress has promised money to allow the VA to hire more seasoned doctors.  Most care at the VA is disabled or senior veterans.  It takes a lot of clinical practice before you can provide the needed care.

But now the medical school effectively has its own hospital where the doctors can go for training. So, between the new VA policy of hiring more season doctors, and the medical school having a place to send their student doctors for training, I am not so concerned with the problem.

But then there is my problem and challenge in getting emergency healthcare.

I BROKE MY RULE AND RAN TO VALLEY BAPTIST TO BE NEGLECTED

According to the ER doctor who saw me, just because you stop breathing, it is not an emergency.  For weeks I had been complaining I was having a hard time swallowing. We now know, no thanks to the ER doctor, when you have a massive sinus infection which has spread to your ears, jaw and throat something as simple as drinking water can cause the back of your throat to spasm, making it impossible to breathe through your mouth.

The natural response to when you stop breathing is to open your mouth and try and get air in. That is what I did. I ran to the roommate's side of the house and banged on the wall so he would come out of his bedroom and see I could not breathe. He did the Heimlich maneuver which was enough to control the spasm.  The move is not only for when you have something stuck in your throat.

Now I am not a doctor who should have caught the problem. But this ER doctor must have had a low grade in anatomy.  You cannot breathe when the blockage is low enough to interfere block both tubes.  The main one for oxygen purposes comes through nasal cavity.  So, if the blockage is at the top of the throat, you can still breathe through your nose.

Well, this afternoon, it happened again when I ate just a piece of ham.  I was home alone and grabbed my throat and started to breathe through the nose.  All was fine. 

EVERYTHING WHICH COULD GO WRONG DID GO WRONG 

When the ER came to see me, he said "what do you think I can do for you." I explained the history and the multiple surgeries and then told him I was losing my hearing again. Again, he said, "what makes you think I can help you?" He made a big point he is not and ENT doctor and just an ER doctor.  If an ER doctor does not believe someone who stops breathing needs emergency care, I do not know what why they are there.

But this is where he hung himself.  I indicated if he could not help me then he should discharge me.  He then pointed out because my BP was 244/114, he could not release me.  I then suggested my BP is evidence something happened?  He was very clear, it was not.  It took over 3 hours to bring me to a safe BP level.

He can see I am in a lot of pain in my jaw and asked if I want a painkiller.   I said yes.  I then offered him a list of my current medications so as to insure there would be no dangerous interactions.  He said he did not need it and then asked which painkiller I wanted.  Are you beginning to understand how easy it was for addicts to get painkillers.

I told him he had to decide and that I was not qualified.  He also ordered something to lower the BP.  They were not that busy, and it still took the nurse about an hour to bring the medications.  The same for the second set on BP medicine and a painkiller.

About 2 hours into my stay, I needed to urinate.  The nurse told me my BP was too high, and I could not get out of bed.  After she gave me the male urinal, she closed the door, and I got up to do my business.  Can you imagine she closed the door on a patient who was barred from getting out of bed.  I had no call button so if I fell, no one would know.

This ER doctor never even listen to my heart or lungs.

Had he looked into my throat he would have seen the swelling in the back of my throat.   I told him I was going deaf again from the buildup of the fluid in the back of my ear. When he saw me, I was coughing from the sore throat.  He put on his mask and refused to come near me.

When my BP was low enough, he ordered me released.  It took the nurse far too long. She brought me some papers, never went over the discharge notes, and in fact did not include a discharge time.  There was no referral to an ENT doctor, nothing  

This is not acceptable care.  

THEN I HAD AN EMERGENCY PROCEDURE IN MCALLEN

The doctor had to drain my ears a second time and place tubes.  His staff worked with me to get a quicker MRI because the surgeon believes based on my examination the infection went to the joint in the jaw.  He needs the MRI before he can proceed.

HAD WE HAD A VA HOSPITAL

From the beginning last February, I would have seen a specialist right away.

I am very grateful to my new PCP at the VA, and the team of ENT and ENT related specialists in McAllen for treating this as an emergency.  Twice now with the intervention of my VA PCP, I was given surgical appointments on less then 24 hours.