www.Govern.Us

[jmoorby]

On at 11PM Thursday night Emily and I were laying in bed chitchatting and occasionally tickling. We were both laying on our backs and my arm was under her shoulders when she reached over and tickled my other armpit. I lunged forward laughing and my laugh instantly changed to a low groan. My arm had stayed under her and my body sat up. There was a loud grinding Crack and we both knew what had happened. I started crying out it pain and said in a pained voice "oh my god oh my god oh my god" and then added in "I just dislocated my shoulder, go get oscar" and returned to the "oh my god's" Oscar is my roommate who, of everyone home, has the most medical training.

The last time it happened I was on a crowded bus in Delhi, and it took a few hours on the bus and in a taxi to get to the hospital, but once I got there it was in and out in less than two hours. Having had it happen before, I have a general idea of what had to happen to relocate my shoulder, but I clearly couldn't do it myself or accurately explain it to anyone else. I was laying on my back with my arm up above my head in lots and lots of pain. The pain radiated and got significantly worse any time I moved. We called another one of our roommates who's an EMT, but was out of town for the night. We also consulted my wilderness first responder book, and pieced together what I knew about reducing dislocated shoulders. Oscar decided to try to do it. He tried a few times, and while he was doing it correctly, he could not pull with enough pressure to get it to pop back in. We decided I needed to go to the hospital.

Oscar and other roommates tried to stabilize my arm while I sat up, but I'd never realized how hard it is to go from laying on your back to sitting/standing up without any rotation of the shoulders. I couldn't do it, it was too painful. I tried a few times and decided to call an ambulance. I don't have any health insurance because I've been fighting with DC Alliance for a month (DC's health care program that in theory is available for all low income district residents but they've been throwing me through one bureaucratic hoop after another for over a month). A pair of EMT's arrived 20 minutes later and came trudging up the stairs to the bedroom. They asked what was wrong and I explained the situation and that it was too painful to get up on my own and I needed to stabilize my shoulder in order to get to a hospital. They said I should just put on a shirt and go. I explained that if I could do that I wouldn't have called them, and they laughed. One suggested rolling my onto a sleeping bag and using it as a sling to lift me off the bed, while they other suggested I take some Tylenol, wait till morning and bring myself to a specialist.

We counter suggested backboards and other items we knew they had in the ambulance that might be used to stabilize my shoulder and help me get out of bed. They refused to entertain that as a possibility. They told me I should just get myself up out of bed and that it was "like taking off a bandaid," and if I did it fast enough it would hurt but then it would be done. After less than half an hour it became perfectly clear that they were not there to help me and so we sent them away. It was $400 plus mileage if I got into the ambulance so we decided we'd figure it out on our own.

I popped 800 MG's of Ibuprofen and decided to try again. This time, with lots of help and support and pain, I got myself out of bed. They wrapped a blanked around my other shoulder and walked me across the street to the car. There used to be public hospitals in DC, but Mayor Williams closed DC General, the last one, a few years ago. Now its only a clinic during daytime hours. I decided to go to Howard University Hospital, because it was closest, probably cheapest, and the only hospital left in DC that has to treat you without insurance.

During the ride to the hospital I rested my elbow on Emily's shoulder, and had constant flashbacks to riding through the streets of Delhi, with JC holding up my elbow, trying to keep it still over all the speedbumps and around the traffic circles. The ride was much shorter, but the roads were no less bumpy, and I still felt and cringed at every single one of them!

We arrived at the hospital just before 1 AM and checked in. A while later we were called in to Triage where they took my blood pressure and temperature but didn't even ask me basic questions like "do I still have sensation in my fingers?".... I was instructed to sit in the waiting room until I was called. Around 2AM I was called to give my insurance information and I said I had DC Alliance because a month ago they said I did, even though it appears as if I might not (they might have "lost" my application). They made me sign a form saying I'd pay the bill etc etc. etc.

Around 3 AM I tried to explain to the person at the desk that I was losing sensation in my hand which meant that either the blood flow was reduced or I had a pinched nerve and that it would only take about 30 seconds to relocate my shoulder but that the longer it went the worse it would get and the more potential their was for permanent nerve damage. He told me to sit back down. At 330 AM, for the first time since I'd arrived at the emergency room, a patient was called from the waiting room into the back.

A while later I asked for ice to reduce the swelling and was told that they would have to charge me and put notes in my file and get it from the doctors in the back, but finally agreed to put a few ice-cubes in a zip-lock for me. While in the waiting room many other injured and sick patrons were complaining about having been sitting in the waiting room since six or seven PM that evening and how ridiculous that length of a wait was. There was a short discussion about getting back in the car and going to a different hospital, but decided that at that point it wasn't worth losing my spot in whatever line I might be in.

It was incredibly frustrating knowing that the pain would go away within a minute or two of a doctor getting around to seeing me, and not being able to have that happen. Doctors kept walking through the emergency room and I just wanted them to take 2 minutes to fix me so I could go home to bed!

At 530 they finally called my name. The pain had been getting worse and worse as the night wore on and as my shoulder became more and more swollen. I followed a nurse into the back and she pointed at a cot in the hall. Sitting, laying, or standing without either holding my arm up for resting it on something was very painful, so I kneeled down on the floor and rested my elbow on the head of the cot. In a few minutes a doctor came and told me to get up on the cot. I got to my feet and sat on the cot, holding my elbow in my other hand. She felt my shoulder for a moment and asked me if it had ever happened before. I told her that it had, while I was in India last spring. She nodded and left. Both my arms were exhausted but i sat there holding it till another nurse came by and asked me to sit in a wheelchair. He asked if I wanted an IV with painkillers before I went to the x-ray room, and I refused knowing it would be incredibly expensive. He then pushed me through empty dark halls to the x-ray room. The nurse there said "I can't work like this" and said "either put your arm down and your hand on your bellybutton or go back and get painkillers until you can," and walked away. The nurse who had pushed my wheelchair looked at me and I started putting my arm down inch by inch.

I got my arm into the required position before the nurse came back to give me x-rays. She put me in front of the x-ray machine and positioned me. I felt odd standing with no shirt and nothing to protect me against the rays of the machine. As she walked towards her little safe protected control room to take the x-ray, I asked why dentists used protective gear when giving x-rays and hospitals didn't. She mumbled something about it being safe and walked away. She took to e-rays, put them in my good hand, and had me sit in the wheel-chair. She pushed it out into a deserted hall and said someone would be back for me in a minute. She walked away and I sat there in the near dark and silence for what seemed like eternity wondering if I would ever be able to convince a doctor to relocate my shoulder.

Finally the nurse came back and pushed me back to the emergency room and asked me to get back onto my original cot. Soon I was asked to go into a room and lie down on my back on the cot. I cooperated and soon the doctor came in. She made me sit up most of the say so they could wrap a rolled up sheet around my chest. She asked again if I wanted painkillers in an IV and I refused, knowing the pain would stop if she just agreed to pull on my arm.

She handed the two ends of the sheet to a nurse on my right side and he began to pull as she began to pull on my upper arm. They quickly realized that the bed they had put me in didn't have locking wheels so they stopped, made me get out of bed and into the wheel chair while they wheeled the bed out and brought in a new one. I laid back down, got re-situated with the sheet and the two of them started pulling against one another.

It was 6 AM and my arm had been out of its socket for seven hours, more than twice the length it was out in Delhi. This meant it was significantly more swollen and took a lot more pressure to relocate it. They pulled against each other while rotating my arm slightly and finally, it slipped back in, the instant relief I'd been waiting for all night. They handed me a sling and I got back into the wheel chair for another set of x-rays. After the x-rays, I was told I was done. I asked the doctor if she had any tips on after care or how to aid in the healing process. She said "you've done it before, do whatever your last doctor told you" and pointed towards the exit.

I left, amazed at how much better care I had received when it happened in Delhi, and realizing how I'd rather get injured in virtually any other city in the world, as long as it wasn't in the United States. I just hope I can convince DC Alliance I am covered, otherwise I hate to see what the bill would be. It was free in India...

[Mr. X]

I believe that most 3rd world countries treat their citizens better than rich countries, because rich countries consider poor peope to be loosers, and 3rd world countries consider poor people to be normal.

[localboy]

I was in Aruba 2 years ago and got off the plane with terrible pains in the chest and back. Felt like someone had a saw going right through me.
Went to the local hospital fearing the worst. They took me in and ran xrays, electrocardiograms, blood tests, and some other type of scan which eludes me at the moment. They put me in a room for 3 days on a saline drip and a painkiller. The doctor came in twice a day. The nurses were in all the time. Checking out and doing some quick math I figured I was in for a $10,000 tab. Emergency room, tests, 3 days in a bed, and doctors care. We went nervously down to the office to pay and the bill was $1500.00 (That is fifteen hundred).

It isn't all the "evil" drug companies fault. It is the whole concept that the doctor, the hospital (a corporation), the insurance companies, the drug companies, all the suppliers all need to turn a profit. All the profit taking adds up.

[MapleCorner]

We were in Prince Edward Island. My mom was mowing the lawn, and ran over a huge underground bumblebee nest, and got stung bad. A while later she passed out cold. We took her to the Souris, PEI hospital, about 15 miles away, though she insisted she was fine. She ended up spending the night in the hospital, and having a doctor called in special to see her.

Later we all went home to Vermont, and about 2 month later my dad came over. He says, Steve, you have a Canadian checking account, don't you. I say, yeah, why. He says, because we got the bill from the hospital in PEI, aand I don't have Canadian money, can you pay it for me. I say sure, I guess!!!,, How much?

It was $10 Canadian, at the time about $7 American. Only charge was for the doctor to come over special to the hospital. All the rest was covered by the Canadian government.

Nobody here in the US believes thais story, but it is true.
_________________
Steve Gallagher
www.picture.net