Saturday, August 22, 2015
If I were a fife player, I would pipe a merry tune. My wife will be back at work, soon. (help me Ian Anderson). My wife is much better. My post is about my wife's battle with health care, and insurance, and long waits to see a Doctor. Our health care insurance does not cover acute life saving meds for DVT. I will not mention the the drug. We are making way, though. She will wreak havoc in the clinic she works at as a nurse on Monday. My Wife, has been a pent up bull for many weeks. Having DVT, and a PE is nothing short of scary to me as her husband, but scary as shit. Discussion: a DVT is a clot in a major vein in the body. When the clot breaks off, it flows through the right atrium of the heart to the right ventricle, which pushes it up into the main pulmonary arteries (left or right). It can then clog a blood vessel that allows for oxygen transfer in the lungs. This may cause shortness of breath. Which my wife endured. She promptly presented herself to the ED and was treated. She was hospitalized for an ordinate amount of time.
Alas, many of the tests, and procedures are not covered by our measly insurance. But our health care system worked for us. My Wife still lives, and works. The key is "works". Many catastrophic health care situations leave a spouse unable to work. Consider a heart attack, when a spouse cannot work. Consider me, and my family lucky. My wife is already passing out gifts to the needy people in our community today. She love's to help people.
Saturday, August 1, 2015
She was at a large hospital in Houston in the ED. I almost had a technicolor bowel movement. She told me she had a pulmonary embolism. Her O2 SATS were 82% on admission. The did a leg U/S, and a chest CT. Great.
Problem was the source of embolism was her peroneal vein in her left leg. Atypical!
Darn, Heck, and H-E-double L!
I clocked out, and went to lend a feeble hand in her admission process: Wheeling her up to the fourth floor into a private room. (Nice) And we got her some food. My wife is a nurse, and is not a typical DVT patient. She is lithe, active, and determined to have her way. She gave me a list of stuff to bring from the house. The list included pink slippers, a favorite pillow, toothbrush, comb etc. I went home to gather things up and grabbed our son and gave him the news.
"Mom had SOB, and palpitations, and pain in her calf. She has a blood clot in both of her pulmonary arteries"
"What" said my son?
I explained it to him, and he shed tears. I told him it would me OK.
We sprung her from the hospital, and she immediately started going through the discharge bills. She found she was charged for two units of whole blood which she did not get in the IV. Her OP prescriptions hit us like boulders: Coumadian, and a shot form of low-moleculoer weight form of heparin. The shots would cost $275 a week. Insurance did not cover it.
My wife is home now, and the doctor bills are mounting. She has a pulmonologist, a blood doctor (Haematologist), PCC, and an endocrinologist.
My wife is a nurse, and she is pissed off.
Discussion: Most DVT arise from the above knee veins. Her DVT is strange. the peroneal veins are typically small veins that run on the inside of the calf, but they are deep veins anyway because they are accompanied by an artery. Hat's off to the Sonographer that grabbed this one. Sadly, many poorly trained sonographers do not scan the PTV's, or the peroneals.
She is doing well.
Sorry for the lapse in posts. it has been an interesting summer.
Sunday, June 14, 2015
I understand that ultrasound microscopes have value. Here is a link
Saturday, May 16, 2015
A study of portable ultrasound in detecting the presence of minor fractures in patients showed that 85% of patients with a fracture confirmed by X-ray had injuries detected through ultrasonography.
You'd still want a radiographer to rule out fractures but emergency clinicians could rule in fractures using ultrasound images, they conclude.
Ultrasound is a high pitched sound wave generated at a frequency of more than 20,000Hz in air, though the frequency changes depending on the density of the objects through which it passes.
Sorry, I have a family, and I have issues. I think everyone knows what it is like to prepare for deaths. My Mom and Dad are in the 80's. We have been going around with the bottom feeders (attorneys). Enough.
Upper extremity U/S is great at ruling out CLOTS!
Shoot I have known this for years, and so have many of the great doctors I work with are great. Here is an article from www.sonoworld.com to put this issue at rest. Thanks Sonoworld!
Single whole-arm ultrasound can rule out upper-extremity deep vein thrombosis with a lower rate of repeat screening than a multi-step strategy using clinical scoring and D-dimer testing, researchers reported.
Ultrasonography has largely replaced venography for the diagnosis of upper-extremity deep vein thrombosis (UE-DVT), despite the absence of diagnostic management studies showing the practice to be useful for determining which patients need anticoagulation therapy, researcher Michelangelo Sartori, MD, PhD, of S. Orsola-Malpighi University Hospital, Bologna, Italy, and colleagues wrote online May 11 in JAMA Internal Medicine.
THANKS SONOWORLD, and JAMA
Sunday, March 8, 2015
Get a go pro for the family, at least to document any car wreck you have for the insurance adjusters. Russians do. :)