Saturday, November 30, 2013

Dr. Kevorkian's Party Palace

I sometimes write trilogies, books connected by characters, setting, and/or backstory. I always encourage readers to start with the first novel in the series and work their way through to the last. Things make more sense if the books are read in order. The funny stuff is funnier. The sad stuff is sadder. The heartrenching stuff is renchier. So for that reason, I politely ask anyone who hasn’t read my previous blog entries to go back and start at the beginning. I promise it won’t take long. They’re short. You’ll be glad you did.
     I’ll wait.
     Welcome back. So we’re all caught up, now. I almost died from an unexplained case of flesh-eating bacteria, underwent multiple surgeries including the amputation of my left leg from above the knee, and  spent about six weeks the UMM Shock Trauma Unit in a opiated haze of agony, fear, and loneliness.
This is where things take an appallingly unfortunate turn. I wish I were making this up, but I’m not.
           It was mid-January. My amputation was slow to heal and my insurance company was getting antsy.  Because I had so many complications, UMM believed I needed to remain in Shock Trauma while on their watch. This didn’t make my insurance company happy. As they pointed out, they were paying top-dollar for me to begin physical therapy and lounge around waiting for my wound to heal. I’ll sidestep all the gory details, but here was the issue: the amputation site needed to be adequately drained and healed before I could receive a skin graft, which would be the final stage of surgery. To aid in healing, a wound vacuum was attached to my leg at all times and I received several sessions of heat lamp therapy a day. As the doctors explained, this process could not be rushed. If surgeons attempted a skin graft before the amputation site was ready, it would almost certainly be a disaster. The graft wouldn’t hold and it would lead to more surgery and more hospitalization, which nobody wanted. So my insurance company decided I should be transferred to a facility that could provide sub-acute care at a lower cost. The plan was for me to heal and receive some physical therapy, then go back to University of Maryland for the skin graft. I really wanted to go to my local hospital’s rehab unit, but the insurance company refused, saying I didn’t meet requirements for coverage at that facility. So I was shipped off via ambulance transport to a nursing home in my town, about an hour-and-a-half away from Baltimore.
My loved ones were so excited. I’d be close enough to visit every day. The ever-optimistic Arleen busied herself with gathering up my sports bras and workout shorts to wear to physical therapy. She even bought me some new pajamas, assuming my hospital gown days were over.
Within twenty-four hours, I was once again on death’s door. The nursing home staff had drugged me with four times the amount of painkillers prescribed by my doctors at Maryland Shock Trauma. When Arleen showed up with my workout attire, she found me unresponsive in my bed. The sling used to hold my arm in place after my pacemaker surgery was now wrapped around my neck, choking me. Apparently, this is the moment my usually demure BFF went completely ape shit. Arleen began shouting for help, pulled the sling from my neck, then proceeded to rip the charge nurse a new one, demanding to know how this could have happened.
The nurse pleaded HIPPA – the Health Insurance Portability and Accountability Act designed to protect patients’ privacy – and said she couldn’t discuss my case with her. Arleen’s account of what happened next still makes me smile. I wish I had been conscious because I sure would have liked to have witnessed it.
 “HIPPA my ass!” Arleen recalls shouting. “Do you HIPPA know what Susan’s been through? Did you HIPPA hold her hand, wash her hair, and give her a spa treatment in the hospital? Do you HIPPA know Susan hates horseradish and makes brownies when she’s stressed?”
Arleen called my ex-husband, John, who’d already been notified and had instructed the nursing home to call an ambulance. Arleen rode with me in the ambulance and met up with John in the local ER, where I began to be treated for narcotics overdose.
Remember my story about The Screamer down the hall in Shock Trauma? Well, this was my turn.
Whether it was withdrawal, the drug ER doctors gave me to counter the overdose, the catheter a nurse was trying to shove in me, or a combination of all the above, I began screaming bloody murder from behind the ER curtain. Arleen and John had been with me through everything – the amputation,  kidney dialysis, dozens of surgeries – and they’d never heard a peep from me. What they heard at that moment brought both of them to tears.
I was wailing like a banshee.
Arleen couldn’t take it anymore. She jumped up and threw the curtain open, stood by my bed, and held my head in her arms. She recalls, “I just told you I was here. That you were going to be ok. That we all loved you and you would make it through this.”
I spent several days in the intensive care unit at my local hospital, slowing coming out of the overdose. During this time, I endured the most sinister nightmares of my life. They were beyond creepy. The dreams featured complicated plots and malevolent inhuman beings, and I would wake up shaking and crying, terrified out of my mind. During this period, I started calling my friend Celeste Bradley. She lives two time zones away and is a night owl by nature, so if it was three A.M. for me, I knew she’d be awake, alert, and probably writing. She talked me off the ledge more than once.
Around this time I started getting collection calls on my cell for care I’d received at the beginning of my health disaster. Yes, that’s correct. I was in the intensive care unit of the very same hospital now calling me about the overdue bill for my ER visit back in December of the previous year. All I could do was laugh. It was just too ridiculous. I told the woman I’d take care of my bills as soon as I was strong enough to hold a pen to write out the check.
At this juncture, I asked myself, “What’s wrong with this picture? What’s wrong with our health care system? WTF is wrong with this country?”
I bounced back from the overdose, and the issue was at hand again – where would I be shipped off to next? I told my doctors and my family that I HAD TO stay at my local hospital. I told them they HAD TO find a way to get me in the rehab unit there, where I could be close to those I loved. I begged everyone from the doctors to the janitorial staff not to send me back to Dr. Kevorkian’s Party Palace.
My insurance company said the only way they would approve that level of care is if I could make several hops forward on an aluminum walker. This seemed impossible, considering I'd just OD'd. I had been plenty weak before the overdose. Now, I felt like a floppy slice of bologna. My good leg was shaky and numb. My arms were wobbly. But I believed I had no choice. My life depended on it. So I did what the insurance company asked. I don’t know how, but I hopped around on the 'effin walker.
As my brother, Sean, observed, “It’s amazing what a girl can do when she’s not loaded up on elephant tranquilizers.”
About a year later, I was doing my regular outpatient physical therapy and learning to walk with my prosthetic leg. A young woman who worked there came up to me with a strange look on her face. She smiled shyly and said, “You don’t remember me, do you?”
This had happened before. I remembered very few of the kind and skilled people who had helped me in some way during my health crisis. I admitted to the young woman that I didn’t recall meeting her.
She told me she had been the freelance physical therapist at that nursing home. She told me that she was instructed to work with me but found me unresponsive. She said she reported to the nurse that I was comatose. The nurse told her to go back in the room and move my leg up and down a few times so they could bill my insurance company for the physical therapy.
I listened to this woman’s story with my mouth hanging open. Then I snapped it shut because, really, was it so hard to believe?
Often during my illness and recovery, I would stop and thank my lucky stars that I had people to advocate for me when I was too weak and overdosed to do so myself. I wondered what happened to people who didn’t have Arleens or Johns or Seans to stick up for them. Now I think I know.
They’re screwed.

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