Friday, March 13, 2015

Consternation On Medication


Myself when young did eagerly frequent 
Doctor and Saint, and heard great argument 
About it and about: but evermore 
Came out by the same door where in I went. 

It used to be an integral part of conventional wisdom that the function of education was to sharpen the faculties of cognition in general and deductive reasoning, in particular.  In this light, except for the fact that I have delved into the subject at length earlier elsewhere {see, e.g., ch. 11, 13, 14, 20, & 24 op. cit.} this piece could have been titled “Consternation with Education.”  It is deemed proper to focus on medication, however, as it has been the trigger issue that incited this writing.

It behooves to emphasize that I do not approach the subject with a smidgen of nonchalance.  Since I chanced into an eighteen-hour open heart surgery on 30-Aug-2007, as described in detail on chapter 22 of the earlier cited “Flirting . . . , etc.” book, I have been in the care of several specialized branches of medicine with routine follow-up sessions at regular intervals.

The gamut of referrals include: cardiology, gastro-intestinal medicine, vascular surgery, infectious diseases, ophthalmology, dentistry, neurology, orthopedics, and hematology.  The last one was added by my primary care physician yesterday, 20-Feb-2015, pursuant to my latest blood work results.

But here’s the proverbial Shakespearean rub:~~ The higher the tally of specialties gets, the more muddled the health landscape devolves into, and the more disjointed the healthcare picture becomes.  The proliferation of widgets is never conducive to the emergence of a coherent gestalt unless tempered with a generous does of deductive reasoning buttressed in common sense.

Lest I be construed as somewhat unhinged, let’s get into some specifics.  On 15-Feb-2010, less than thirty months after the open heart surgery (30-Aug-2007) gave me my aortic valve implant and quadruple cardiac bypasses, I was diagnosed with a Transient Ischemic Attack (TIA) and got Plavix 75mg in the bargain.  This was roughly coeval with getting cobalt-cadmium stents in all four cardiac grafts.  I learned then that I was to be on Plavix while I keep the cardiac stents; meaning, for the rest of my natural life, or until an alternate for Plavix is embraced by the health care community.

In early spring of 2013, a shade over three years after I was on Plavix, I ended up at the Intensive Care Unit (ICU) of the GI Department at Stony Brook University Medical Center (SBUMC) with internal bleeding.  At home, the external manifestation of my malady was Black Diarrhea and overall weakening of my constitution.  I was simply too lethargic to do anything else beyond calling an ambulance.

It took me all of twelve hours at the ER for routine testing protocols, one week at the ICU and one more week at the general ward for follow-up observations.  In that interim I got two units of blood transfusion to remedy my low platelet count.  I learned that I only have half a liver left, and that I had advanced esophageal varices which were made to account for the internal bleeding.

In the bargain, they sent me a legion of narcotics drug and/or alcoholism addiction counselors, preachers and kindred soldiers of good intention in an endless cavalcade with the view of recruiting me into their fold.  It seemed to have not occurred to the powers that be that internal bleeding has been a well-known side effect of Plavix, if one bothered to search extant literature, available in cyberspace as far back as 2006.  I was retrofitted into a ready-made demographics and sociological template of health care provisioning with nary a regard for my medical history.

A cursory attempt at making a coherent gestalt of my medical landscape would have rendered my being on Plavix an obvious factor contributing to my proclivity for seemingly unprovoked bleeding.  That it is not being done as a rule makes it more frustrating for us on the receiving end.

I am aware that everyone engaged in health care provisioning of sorts, wittingly or unwittingly, has taken the Hippocratic Oath although it may not necessarily be in a formal sense.  It would not hurt to give everybody the benefit of the doubt.  Most of the time, though I cannot avoid the feeling of their having made the scenario a bit more complicated than it could have been with a moderate does of common sense.

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