Yesterday, two other vets and I started talking about our various predicaments in dealing with VA health care. My story has already been covered in the last two posts, (first two?,) to this blog, so after a quick update on my situation, and it’s total lack of logic, I’ll give two more examples of the same doctors making very similar mistakes with disastrous results for the patients.
In my situation, the head of ortho has decided that the people on the spinal cord unit, who deal with tunneled sores of various types all the time, don’t know what they’re doing, and has convinced my doctor to stop putting the gauze wick all the way down into the infected tunnel in my right thigh. His reasoning is that somehow, by having that wick draw out the fluids and pus in there, it will cause pressure and an abscess, (one of several abscesses working it’s way to the surface is what led to this little hole opening up and draining to begin with,) and so the orders been changed so that now they’re only putting 3-4 cm of wick into the 8 cm deep hole.
When I pointed out to my doc that this doesn’t change a thing IF it was going to block up that hole and prevent drainage except to allow a larger area for the infection to fester in that tunnel rather than having a Dakin’s solution, (saline with 5% bleach,) soaked wick in there, and he agreed and said in a few days they’ll probably stop with the wick entirely and just have it drain. Why the wait? I have no idea. My worry is that that particular abscess will drain enough that the hole will close off, and since the “seed” of the infection, (it’s a staph infection in there,) will still be there, it’ll just regrow. We’ll see if it does close off or not, and then try to get them to act accordingly…
So… On to these other two guys!
One is a paraplegic, wounded in Vietnam after getting shot through the gut. A number of years back, podiatry came down to trim his toenails, (they don’t’ allow the nurses to do this for some reason,) and cut his nail on his big toe down to the quick. A few days later, his toe had turned bright red and was very swollen. He asked them to do a culture, and they refused, saying it wasn’t an infection but just irritation.
As he was trying to get treatment for an increasingly severe problem in his foot, the infection they’d given him ate the first two knuckles on his big toe, moved along the bottom of his foot and into his heel. The VA put him on antibiotics, but it didn’t stop the infection’s progress, only slowed it. They didn’t believe there was any real problem until, while in the shower, as he was washing his foot, his heel came off in his hand.
Then, it was suddenly an emergency, and they ended up amputating his leg below the knee. He’s still got the bone infection in his leg, but says it’s gone dormant and hasn’t moved in several years now. They want to take his entire leg off, but since he’s already terminal with lung cancer, he’s refused.
The second fellow is not spinal cord injured, but helps the recreational therapist out to pass his time. He came in a couple years back with what he thought was a spider bite on the back of his leg, with just a small black spot in the center of a red swollen area. They told him it was nothing to worry about and sent him home.
It got worse, and each time he came in, they would apply superficial treatment, never sending him for more extensive tests, and again send him home. An open sore developed, and they dressed it and still again, sent him home. This only got worse, and when they finally did culture the wound and send him for the proper tests, it too was a staph infection. In his case, the infection went septic and he was admitted to the ER and when they removed the latest dressing, his lower leg was green and emitting a foul odor, (gangrene.)
They ended up amputating this previously able bodied vet’s leg as well, and now he’s suing the VA for malpractice.
As just one other example that comes to mind, on my third trip to Puerto Rico, I broke one of the bones in my lower leg. I heard and felt it break. This was on a Sunday evening, and the girl I was out there to see, her daughter and I were going to go out to dinner. We went to the VA Emergency Room instead.
Because I wasn’t hollering and yelling about the pain, (I’ve developed a pretty high pain threshold over the years,) and because they didn’t have my patient records there, they sent me home without even sending me to get an X-Ray, telling me to come back the next day during normal hospital hours.
I did go back the next day, and golly gosh almighty! MY LEG WAS BROKEN! They put a cast on it, (a huge no-no with spinal cord injuries since the leg can swell can cause a pressure sore, though I didn’t know it at the time,) and told me to check in with the VA back here in town after I got back home. I did, and they changed the cast out for a removable brace, (called a “Bledsoe Boot,”) so I could check my leg for problems and adjust how tight the brace was on my leg to keep it immobile but allow for swelling if it occurred.
The point though is that the VA’s ER sent me home with a broken leg, refusing to do even a cursory check, telling me to come back the next day. That night I was wondering how I’d suddenly caught a cold since my nose was all stuffed up, and it turns out that is one of the symptoms of “autonomic dysreflexia”, a condition that high level spinal cord injured patients can have start if there is pain or discomfort below the level of injury, and which is potentially fatal since it causes the blood pressure to go way up, potentially causing a stroke or heart attack. (I was unaware of this particular symptom of disreflexia as well until afterwards.)
This is why I argue so vociferously against any government run health care system for the general public, and why those who advocate for one citing the VA as an example, frustrate the hell out of me in the pure, unadulterated ignorance they spout. Most wouldn’t know where their local VA hospital was if their life depended on it, much less have ever been inside one or spoken with the people who’ve dealt with the VA for any length of time.
And… (a personal gripe here…,) the ones advocating the loudest for government run health care are the self same people who, back before it became non-PC to so, were the first to damn veterans as baby killers, look down their noses at us, and even spit on us. Hell, just a couple years back, right after Obama took office, Napolitano issued that secret document to law enforcement, (that ended up being leaked,) that warned of how the biggest terrorist threat the US faced was from conservative Christians who owned guns and had served in the military.
The same politicians who repeatedly, administration after administration, Democrat and Republican, swear up and down how they are going to, or have, improved health care for our veterans, are the ones who ignore the problems that have gone on in the VA system for decades.
Visit your local VA sometime… Visit the wards and talk to the patients… Find out the reality for yourselves. You may just find yourselves shocked by what you hear…
Dave
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