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Surgery update: I am recovering well. I am home. I am astonishing and impressing every doctor and physiotherapist with how generally sprightly I am.
The physio I saw this morning was also slightly awed by my collection of doctors, since I have basically The Best Respiratory Physician, The Best Sleep Specialist, The Best Oncologist [For Lungs], and The Best Cardiothoracic Surgeon.
It just sort of happened? I needed a respiratory specialist and The Best One was still taking new patients at that time, and he referred me on to the sleep specialist (who works with him) and the oncologist, and the oncologist referred me to the surgeon.
Exciting Life News Update:
So. In 2021 I had a hysterectomy I didn't want (also because cancer; I continue to blend Very Lucky and Very Unlucky, in that I've had TWO cancer findings at the age of 42, which is A Lot and Very Unfair, but also they've both been caught early enough that it was handled surgically with no chemo/radiotherapy required).
I was devastated. It was a whole grief process, especially because I hadn't quite given up hope of motherhood, which I desperately wanted. I thought I'd never have the chance to be a mother and I cried a lot and all of that.
Except.
IT TURNS OUT.
I am in fact going to be a mother.
I'm just not going to be the one getting pregnant. I will be one of my kid's three parents, because ![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png) velithya is pregnant and I'm going to be co-parenting.
Special mention of gratitude goes to the sonographer who did the fourteen-week anatomical scan (everything looks perfect!). She worked late to add us to the end of her list a couple of days before I had lung surgery specifically so that I could be there for the scan.
I would have been devastated to miss it. The baby was doing somersaults and flips and kicky feet and I got to see it, and it means so much to me. I got to watch as the sonographer zoomed in to count fingers and thumbs and have the reassurance of watching as she checked that blood vessels are going the right way, all four heart chambers are there, all of the everything.
When my child is old enough to understand the words, I will never be saying, "Just be normal!"
But at this point, "everything's normal" are sweet, sweet words to hear.
There's no range for being, like, better than normal at this point. At this point I want normal. Most of all I just want healthy.
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"It's the most painful operation you can have on your body." - my surgeon, this morning
It doesn't make most of the lists of you google "most painful operation" but they usually just list orthopaedic surgeries, and I can definitely state with absolute confidence that at least one of the ones mentioned isn't nearly as painful as having a cyst removed can be, so there's that.
Really, these things are so variable and subjective!
He seemed mildly concerned that I'll have an unpleasant time because of how many painkillers I have adverse reactions to, but that's a discussion to have with the anaesthetist.
My surgery will be on the second of October, which is at least a couple of days after velithya's birthday. I go into hospital the night before and come out... at some point. It depends on various factors to do with how the surgery and recovery go.
Unnerving comments notwithstanding he seemed very nice.
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Sep. 16th, 2023 @ 07:01 pm
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Me, a fool, on Saturday afternoon: Man, it sucks that we're not going to hear from the surgeon until at least Monday.
The surgeon, Saturday, 6pm: "Sorry to call you so late. Are you available to come see me at 10:30am tomorrow?"
My oncologist, my respiratory specialist, and a cardiologist to whom I am socially connected are all in agreement that this guy is a top tier cardiothoracic surgeon.
I don't know why I would have expected him to take weekends off.
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... that the ability to compartmentalise in a crisis doesn't mean you don't have the emotions. It means you postpone them.
It's such a weird thing. Yesterday through last night all the terror of Wednesday's medical misadventures hit me in a rush.
I spent a lot of time verbally rationalising. Both why it was okay to be afraid - you know, the experience I went through being legitimately terrifying actually - even though it was two days later, and also why I wasn't in serious danger at the time.
Because the whole thing would have been genuinely life-threatening outside of a hospital situation, but I was in a hospital, so it wasn't.
They had oxygen tanks on hand. If I'd needed a transfusion they would have had the supplies on hand and I was already cannulated so they wouldn't even have had to mess around trying to find a vein. There was a doctor right there. There were nurses right there. Guaranteed if they needed to call the crash team that will have been something they could do in seconds, and hospital crash teams don't fuck around. (We had to call one for my mother once. They turn up astonishingly quickly.) They had a pulse oximeter on my finger pretty much as soon as the problem started and they were watching my saturation levels very closely.
I was fine.
And on some level, for all that I was, in the moment, clear-headed and outwardly calm, on some deeper level I was also absolutely terrified and that's okay too. That was a scary thing to experience.
It was, mind you, a lesson in why that kind of compartmentalisation - which my parents do, too, I have no idea if it's genetic or learned or what - is generally speaking a very good thing, I think.
Because if I'd been feeling that terror in the moment? If I'd panicked? That would have made the situation so much worse and I might in fact have had to have the really unpleasant outcomes. If I'd started hyperventilating I would have been in so very much more trouble.
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Yesterday I went into hospital to get a biopsy done on the Thing In My Lung. It didn't go well.
( Content warning for blood, needles. Both of them But More So Than Normal. )
The nurses complimented for being a "total trooper" and "possibly the least distressed person in the room". I explained to Emily that from my perspective, while it was a really, really unpleasant experience, it didn't really feel all that distressing. Like, medically and legally, they were the ones who were responsible for figuring out what to do about it.
Emily acknowledged that that was really true in a way that suggested she might try that as a way of reassuring future patients who are anxious about stuff.
As far as I was concerned, my job was to do what they told me to do - like rolling over even though it hurt a lot, for example, and not sitting up until they said I could - and wait for it to be over. There were no decisions I had to make.
After he finished his office hours my oncologist came up to talk about it. He was a bit distressed, because they don't like they don't have an absolutely definite confirmed diagnosis of the lump to go on, and the next step is a lobectomy. They'll discuss it at their multidisciplinary meeting, but it's nearly certain now I'm going to be losing the middle lobe of my right lung.
(Good news: it's the smallest, apparently.)
(Also: my left lung only has two lobes to work with TOTAL and it was doing a pretty good job! 80% is a good effort! With twice as many lobes I'm sure I'll do okay!)
I pointed out to him that since it's growing it'll quite possibly cause me problems eventually even if it's benign, and a full best effort had been made in good faith to get all the information we could. It's just that the lump in my lung is in a really, really unfortunate location, and pretty much unreachable without doing me Significant Harm.
I am good at reassuring my medical people, I guess. The nurses in the lab seemed to get a lot calmer when they realised I wasn't panicking, which makes sense, because if I'd been panicky and, say, hyperventilating that situation would have been a LOT worse... and still their responsibility to handle.
Anyway. Today I am still somewhat sore and absolutely exhausted. My body does not seem to have appreciated that experience. In fairness, it had to grow some new blood as well and that's probably quite tiring to do all in a rush.
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We've moved house!
Also since my last post I've had abdominal surgery to remove a 10x10cm paratubal cyst, come off opiates, gone through withdrawal, and made substantial progress on the process of actual grief it turns out you go through when you find out that you're never ever going to have kids because you need a hysterectomy to remove your pre-cancerous uterus.
In the course of the last surgery they took a bunch of samples of my uterus and uncovered the early stages of a plot to murder me. Murder-uterus has been served with an eviction notice, surgery date is still unscheduled.
I'm anticipating it being in the next few months, but it's not hyper-urgent enough for it to be happening just yet. Probably going to be delayed a little further by the UK variant breaking loose in Perth.
The new house is really nice. We liked our old house, we lived there for twelve years, and now it seems so awful. (Doesn't help that multiple things just... went wrong, recently. Like the range hood broke down and the ancient wall unit for the aircon was going critical (so fucking loud, oh my god) while this place is newly-built and just... so nice.)
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Home!
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May. 15th, 2013 @ 12:01 pm
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Out of hospital already yaaaay.
My roommate was non-annoying!
My knee is Not Too Bad (tm). I currently have very mild pain (sitting on the couch, no weight on it) but then the Panadol will have worn off - it's worth noting that my pain is currently manageable even when walking on mere paracetemol.
It also no longer makes crackling sounds when it bends, which pleases me and which the surgeon said was a good sign.
Apparently there was some developed roughness under my patella, so they shaved that off all smooth or something. Then they did the "lateral release".
I am tired, due to not sleeping that well in hospital, although more than I did last time due to non-annoying roommmate (although someone a couple of rooms down needs to see someone about his sleep apnoea) and also having had velithya and myfyr bring my pillow from home to sleep on. My pillow is nice, I'm used to it, it's the right firmness and the right thickness, it smells right and not of hospital laundry, and also, isn't plastic.
(The pillows at StJoG Subi are decent, for hospital pillows, at a good point between soft and firm, etc, but they still have plastic casings because otherwise they'd have to burn them after single-patient use due to risk of infection transmission. So their nice, soft cotton pillowcases are still nice, soft cotton over plastic, which is never, ever going to be as pleasant to sleep on as My Pillow.)
So I managed to get actual sleep, despite things like being woken at 2am to have my blood pressure checked.
(The saga of my b.p. during my stay: Slightly high for the first few, then 124/87, then something like 120/57, and then I was released. >.>)
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I'm not necessarily going to succeed at catching up for another few days at least. On Tuesday I'm having surgery on my knee. It turns out my kneecap is in the wrong place and needs to be moved.
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... way behind on reading journals. I was keeping up, but there was a whole thing, that upset me, and I was all journal-aversion again for a while. If I loved you before, I totally still love you.
I had an MRI last week. It was distinctly painful, because the problem being investigated is my knee, and a major symptom of the problem with my knee is that I can't lie on my back with my leg straight, it makes my knee hurt, and the MRI was 20 minutes of lying on my back with my leg straight and a sandbag on my shin to hold it still. Which also means it was not even just straight, probably, it will have been bending slightly backwards, because I am mildly hypermobile and my knees bend slightly backwards and always have.
And I had to pay $95. After pension discount etc.
After the MRI I had a pelvic x-ray. The tech asked if this was checking on my hip replacement(s). I'm 32. (Also, the initial setup was done by a trainee, who was very nice, but I had to tell her that no, I didn't mind if she pressed more firmly locating my bones, because her carefully gentle touches tickled. She had made sure it was okay to touch me at all first, that was fine, but I hate being tickled and also it kinda makes it hard to hold still.)
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"Crepitus". That is, apparently, the technical term for "joints making noise".
It's on the report I got with the knee x-rays I had taken yesterday. Since I regained walking after breaking my leg last year, my left knee has tended to make a crackling sound when I bend my left leg with weight on it (e.g. when I go down stairs). It also is rather hurty. My right knee is silent under bending, and only gets hurty under compensation strain occasionally.
I've had a referral for an x-ray for a while, but what kinda prompted me to actually get around to doing it is a) a doctor's appointment tomorrow and b) the discovery that taking up regular walks to strengthen all my muscles does not, in fact, improve my knee pain, but rather worsens it considerably.
Most of the report on the x-rays is largely incomprehensible to me. With the aid of Google I've determined the following:
- The fracture of my fibula, last year, has healed up with "cortical bony thickening". I'm pretty sure this is normal. My fibula is STRONGER and MORE BADASS now.
- There's a cyst on my patella, apparently? This is somewhere on a spectrum from "no big deal" to "hey good thing we caught this cancer so early".
- There is fluid on Hoffa's fat. Obvs I am looking this up, but I kind of want to just be all WHO IS HOFFA AND WHY IS HE LEAVING HIS FAT IN MY KNEE. MY KNEE IS NOT FOR OTHER PEOPLE'S FAT.
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So, I've started making a proper effort at getting back into something resembling shape.
It's really driving home to me how self-reinforcing injury can be.
For three months, I couldn't put weight on one leg at all, and being on my other foot moving around represented a high-risk scenario for serious further injury, so I avoided it as much as possible.
I got back to the point where I could walk around the house, somewhat, but then I sort of stalled. Getting sick here and there didn't help, depression doesn't help, but ultimately it boils down to this: spend enough time immobile, and standing, walking, anything, becomes incredibly difficult and painful.
I feel shame to admit this, but at the moment, I literally can't stand up for more than a couple of minutes, tops, without something to lean against. I start experiencing pain all over - my back, my abdomen, and my ankle are the worst.
I can walk on a flat surface barefoot, but wearing shoes, or walking on any kind of slope, gives me ankle pain within a few steps, generally. Which makes me want to avoid it, which means... it doesn't change.
So I'm working on it. I've started going for walks with my housemates - short walks, so far, but walks, outside, where the street outside has a slope enough to work the muscles that a flat floor doesn't. I'm making a point to stay on my feet a little extra, any time I get up, to work on all my standing-up muscles.
It's harder than it should be. And it's sometimes disconcerting. Take standing on tiptoe, a not-at-all weird activity I didn't think twice about before I broke my ankle. On my right foot, which retained all the strength plus some thanks to doing the work of two for several months, it doesn't cause me any issues. I can stand on my toes, even on one foot, until I either overbalance or my calf starts to cramp. (Static muscle work is still static muscle work, after all.)
On my left foot? Not only does it still feel like effort, but I get *out of breath*. That is a weird and disconcerting thing, because it just feels like it shouldn't happen. I don't feel like "standing on my toes" should qualify as that much exertion, and yet, for my left ankle, it totally does.
But the point is, it's a start. I will get back to the point where so long as I can maintain my natural pace, I can walk all day without a problem. I will get back to the point where the limit to how long I can comfortably stand around is defined by when my feet get tired, not by when the rest of my body gets tired of supporting itself.
Hell, I will get back to the point where I can walk at my natural pace, where the muscles in my left leg and ankle can support the stride I once had. I still walk timidly, taking careful steps half the length of what my steps used to be.
I WILL WALK LIKE A GROWNUP AGAIN.
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So, earlier this morning I was looking at options for renting a motorcycle for the few days I'll be on my own in the US in October - contemplating getting a bike and seeing some of America that way.
However, I've come to realise that that's just not a good plan, for one simple reason:
Bikes have a higher chance of an accident, or at least a higher chance that in the event of an accident, you'll be injured.
And the thing is? While I've been injured before, and even injured in motorcycle accidents, and I could handle it, those incidents all happened in Australia. Not only did this mean that I had my family and/or friends to help me deal with recovery, it meant that any professional intervention I required happened in Australia, too.
I truly dread the prospect of having to deal with the American health care "system". Yes, I'm getting travel insurance - because you can't guarantee you *won't* need health care - but I just can't take the risk on a bike.
I'll save my Amazing Motorcycle Holiday Dream Journey for Tasmania or New Zealand, still. Because I pretty much trust Medicare - my badly-broken leg was treated excellently - and New Zealand's system is relatively similar to Australia's. (Plus New Zealand is near enough that it is conceptually feasible that if I were injured there, I could still make it home again even while I was still recovering.)
I have a sense of breakability I didn't used to have, since 27/12/11 marked the first time my body actually, truly broke - always before I'd been injured, but largely structurally intact. That had nothing to do with bikes, but I'm aware that I *can* be hurt that badly on a more visceral level than I used to be.
Nothing I've ever heard about the health care experience in the USA suggests that, really, any part of the process of treatment and recovery I went through would have been handled even close to as well as it was handled here.
And even if the medical staff were exactly as kind, exactly as pleasant, and exactly as competent, even if somehow the astronomically-higher medical costs were handled by the insurance without being stressful for me (which I doubt) and didn't cost me anything out-of-pocket (ditto), I think it would be vastly more stressful and unpleasant and difficult to deal with just because I'd be in a foreign country, which has to it an inherent level of alienation.
Here, I got treated by people with familiar accents and familiar cultural preconceptions, and while I was in hospital I was visited daily by family and friends.
Somehow I don't think as many of my most beloveds would make it to my bedside on another continent.
So. Bikes are too high-risk for tourism outside of Oceania. I have decided.
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This morning, I bought a pair of roller skates! My first pair of new skates since my eleventh birthday, if I remember rightly - when I grew out of them and went to replace them, I got rollerblades, which, frankly, I regret to this day. I was never as comfortable in them, the buckles never seem to make them as secure on feet, etc - I prefer skates. (But skates were hard to find, for a while, because suddenly it was all about rollerblades.)
But this morning, in conversation, velithya discovered I love rollerskating (and the idea of doing it again makes my face light up with joy and delight), and I discovered that velithya really likes rollerblading and has been wanting someone to do it with.
So we went and I bought a pair of skates. Also kneepads and wristguards, because I'm unbelievably out of practice, and I'm also 31, and on the hefty side, and so I'm less likely to bounce back from falling over as readily as I did when I was a child regardless - and I already have a slightly dodgy knee from past injury aggravated by getting wrenched around and then strained with heavy casts when I broke my leg.
Add to that: When I did a little run on the skates to see if they fit nicely and so on, I felt really, really nervous and unsteady. Partly that's being so out of practice, and partly I was terrified of falling and landing on my knees, because it would hurt like crazy. Kneepads will let me overcome that fear.
I got proper boot skates. These days it seems you can get below-the-ankle ones, basically sneakers with wheels, but I'm not willing to risk skating without ankle support. Bending and rotating my ankle can be painful - twisting it would be agony. Definitely boots.
Five or so minutes on skates had my ankle muscles aching, but pretty much in the good way. This should be a good way to build up my strength and fitness again. And it just felt so good to be on skates again.
The guy where we bought them recommended I take lessons. I felt super-weird about it. Rollerskating lessons are some of my earliest memories, and I loved them, but now the idea gives me this kind of offended pride feeling. Like rollerskating lessons are beneath me, I've been rollerskating as long as I've been walking I mean how dare you, and yet... probably actually a good idea.
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I just took the dressing off my ankle (the doctor told me to leave it there until Saturday).
I'm pretty pleased with it! There was some dried blood on the pad, but not that much, and the incision looks good - healing well, and even smaller than I'd expected. There's only two stitches!
A week and a half until the stitches are due to come out, and then I'll offically be done with direct medical procedures on my ankle. WHEE!
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Since I just realised I hadn't made a post in like two and a half weeks:
The broken leg is healing well. I'm now allowed to put *some* weight on it, but I still have to wear the broken-leg-boot and use the walking frame.
I'm discovering the degree to which I prefer to be snacky about food - since I can't, for example, carry anything while walking, velithya leaves my lunch and some snacks by the couch for me before she leaves for work.
I've developed a tendency to eat half my lunch mid-morning, and the other half at actual lunchtime. Which is actually optimal, without the hypoglycaemia thing, but usually I forget to go and get food until I'm waaay too hungry and low on blood sugar, which, you know, bad.
Stonefruit season is starting. Dean also got me some plums and nectarines which are in a bowl near the couch now, too. Yum.
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Yay, SOPA/PIPA are dead for now! That's awesome.
Imagine how much better life in America could be if the good people of the country could be stirred to speak up this way about trivial issues like health care reform, as well as vital matters like internet access?
I'm not saying that SOPA/PIPA weren't important, by the way. But America's current health care "system" is literally killing people, and metaphorically killing the American economy in very real ways.
I'm not going to go into details about that, but what I am going to do is talk about my recent experiences with the Australian health care system, and invite Americans to compare this tale with their own experiences and expectations in the USA.
On the 27th of December, I slipped on the stairs and, it turns out, broke my leg in three places.
We went off to Sir Charles Gairdner Hospital, I think the biggest emergency (and teaching) hospital in the city. (The other major one is Royal Perth; there are smaller hospitals dotted around the suburbs, of course, but those are the big ones. (Charlie's is the one nearest our house.))
We arrived at the emergency room at around 8:30 or 9am, I think. There were one or two people in the waiting room, but after a brief interview at the triage window, I was taken inside for examination, having been designated Fast Track.
Fast Track means your case is not critical, but *is* simple; when there's a free spot, you're taken to another room, inside, where doctors treat you promptly. From the times I've been there, usually everyone in Fast Track has some kind of painful, yet not life-threatening injury. If your case is likely to be more complex, you go to Observation, where there are many more doctors, and many more beds, and they're going to work out what exactly is up and how to treat it. (If you've arrived with a broken bone, or anything similar, there is a well-established protocol for how they're going to treat it.)
There's a big poster in the waiting room about their targets: the designated performance target for the Emergency Department is to have 85% of patients either admitted to the hospital or discharged from Emergency within four hours of arrival. Underneath, they write in how they're doing; when last I saw the board, they were at something like 76% overall, with 96% of patients who weren't admitted to hospital being released within four hours.
So. If you turn up at the busiest emergency room in the city, if your problem doesn't require hospitalisation, you've got a 96% chance of getting to leave inside four hours. If you do require admission, you've still got a 76% chance of being out of Emergency and in the hospital proper within those four hours, even taking into account time they may spend observing you and whatnot to make that decision.
Note that this does not mean that, if you require serious medical care, you are denied it - it just means that if it's not something that can be treated quickly and turfed out, the patient should be admitted to the hospital proper.
This is what happened to me. X-rays of my leg showed that I had snapped both my tibia and fibula just above the ankle joint, and the fibula again just below the knee. This qualified my injury as an "unstable fracture", which would require surgery to treat. A visit from the orthopaedic registrar followed. The ortho reg explained the surgery to me, and I signed some paper formally acknowledging my informed consent to the process, and I was wheeled out of Emergency to the fifth floor.
Sadly, I didn't get a private room - the hospital was under a fair amount of pressure for beds, as the private hospitals to which many private patients might have been transferred were all largely closed for the Christmas holidays.
Still, I was put into a room, a Jones Pillow was fetched to hold my ankle well elevated, and there I was in hospital.
It was three days before I had surgery - an ORIF procedure can't be done before the swelling has gone down, because you need enough loose skin to be able to close the incisions again. During those three days I was given gluten-free food that was really quite edible, and a steady supply of pain relief medication from friendly and pleasant nurses.
While I was waiting, I had a visit from a lovely woman from Occupational Therapy. She was there to discuss my equipment needs - what I'd require to be able to go home, and live my life safely. Around Thursday, I think it was, someone from OT went to my house to survey the situation - measuring distances, herself hopping from toilet to sink to couch, and suchlike, to calculate how exhausting it would be and what would be necessary in a given day.
Several of the people who passed through stays in my room were from outside the city - they'd been injured in deeply rural areas, and flown to Perth for treatment.
On the Friday I had surgery. I was wheeled to the OR's anteroom. Surgeons came over to introduce themselves, then the anaesthetists - two qualified doctors and a bashful-looking student. A few minutes later, I was taken into the OR itself, where more people introduced themselves - nurses, from the surgical an anaesthetic teams, mostly, giving me a sense of who this crowd of strangers was.
There were friendly, reassuring comments at my visible nervousness, people warmly telling me that it was okay, they did this every day, they knew this was strange and scary for me but it was totally normal for them, I'd be fine.
And then I was put under, and I woke up back in my room on the fifth floor.
Back there, the nurses supplied me with more painkillers, through the initial phase of post-surgical pain, than I would have thought possible. I had slow-release oxycodone, quick-release oxycodone, paracetemol, ibuprofen, and some tablets that I don't know what they were that you put under your tongue and wait to dissolve. They taste horrible, but they take effect really quickly, and are on a separate cooldown from the rest.
Thanks to this raft of medication, I was almost never in very much pain at all. Most of the time my freshly-drilled-into bones were a faint, easily-ignored ache in the distance.
On Sunday, it was decided by the doctors that I could go home. But, as the woman from hospital administration who came to see me explained, the physiotherapists and Occupational Therapy were refusing to sign off on my discharge.
"Yes, they talked to me about that yesterday," I said. "They want to make sure I'll be safe. They're coming later this morning to make sure I have the equipment for home, and the physio is going to be making sure I'm able to move around like I need to."
And so they did. The OT and physio brought a mobile wooden platform, so that I could, with assistance and supervision in the hospital setting, practice using a walking frame to hop up a low step - because there is a low step to be navigated in order to enter my house. Once I'd managed that properly, they assembled the equipment I was being assigned to take home with me.
This included:
- a seat with rails and so on to go over the toilet
- a shower chair
- a walking frame
The only thing they weren't supplying was a wheelchair. The hospital only provides those if you can't move without one at all, because they don't really have enough to do otherwise.
After that, all that was left was to wait for my medication bag. This was a plastic bag the size of a small pillow, containing a sharps container, thirty Clexane needles, and boxes of my anti-inflammatories and various painkillers.
Once that arrived, I was officially discharged. An orderly came to wheel me down to the hospital doors, while Dean, who had come to collect me, pushed the trolley loaded with the equipment and my bags, and so on.
A couple of days later a letter arrived, giving me the date of my next appointment at the orthopaedic clinic. I went to that, and got my stitches removed and a shiny new cast applied. In a few weeks I go back again, and get the temporary screw removed.
All of which amounts to a really quite excellent standard of care, I'm sure you'll agree. But would it bankrupt me? How much did I pay for all of that, you might wonder?
The answer: Absolutely nothing.
Not a cent. I was not presented with a bill, in person or by mail. Not even for the bag of medications to take away with me. No-one asked for anything except my name, my date of birth and my Medicare number.
And if you're American, don't be mistaken about what it means to have Medicare here. Medicare is not some special subset of care for old people, or poor people, or whatever it is there. In Australia, everyone has Medicare. Everyone. If you are a citizen or permanent resident of this country, you have Medicare. (If you're a tourist, the emergency room will take care of you anyway, by the way.)
How is it funded? Easily enough - when additional money was needed to pay for Medicare costs, the government introduced the Medicare Levy, which is paid alongside income tax, but is separate, because the Medicare Levy is only paid at all once you get above a certain income threshold. Effectively, the wealthy, who can afford and often have private health insurance, subsidise health care for the poor.
When this was introduced, the general reaction of the Australian population amounted to: "... That's fair."
The fact that the Australian government has a vested interest in health care costs has a raft of added advantages. Various medications that are sometimes necessary for people's survival, but which are very expensive, are subsidised by the Pharmaceutical Benefits Scheme; there are drugs which cost thousands of dollars a month, but which Australian patients will pay perhaps thirty dollars a month for - or less, if they have a pension or low-income Health Care Card. (Most of my meds are covered by the PBS; now that I'm on a pension, they're three or four dollars a month, where before they were over thirty.)
So if, for example, you're unemployed, the government further subsidises any health care costs you may be incurring.
Meanwhile, Medicare has a heavy market power with which to negotiate drug prices with the companies that manufacture them, which helps keep the costs down in the first place.
As of the latest statistics I can find, as a percentage of GDP, Australia spends 9.5% to America's 14.6%. Per capita, we also spend much less money in straight dollar costs. And our costs aren't rising as fast.
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I'm not really reading my reading list at the moment, mostly because I'm spending a lot of time being really grumpy and I fear saying something I'll regret when I'm not.
I'm grumpy, of course, because of ongoing pain and inconvenience due to having a broken leg, as well as all my Hilarious Cast Adventures.
Put it this way - I broke my leg less than a month ago, and I'm on my sixth cast.
( Hilarious Cast Adventures, explained. )
Number six is doing okay so far, thankfully - but I'll be getting number seven on Thursday, at my next ortho clinic appointment. It's projected to last a few weeks before it has to come off too. After that, though, I should get a "removable boot", which will be awesome, because the prospect of being able to have a shower, a proper shower, without having to worry about keeping a cast dry is thoroughly appealing.
Not as appealing as the prospect of being able to stand on two feet or walk again, but that's much further away, and too depressing to think about. On the bright side, the muscles in my arms and my right leg have strengthened enough now that moving about as needed is no longer so painful and exhausting. (I'm not as fit as I'd like to be, but I don't really count it against my fitness levels that my muscles did not appreciate the radical changes to my methods of locomotion in the last few weeks - I was never going to be accustomed to hopping and/or holding my weight on my arms this much.)
This experience has brought home to me, mind you, the notion that the "not disabled" are better referred to as the "not yet disabled". I wasn't significantly physically disabled, but right now, I am, and it is, in fact, incredibly frustrating to deal with even when everyone around you pretty much couldn't be nicer, which I've been lucky enough that they have been. And it really is awfully easy to find yourself abruptly shunted into the Disabled category.
Accordingly, "poor wheelchair accessability" has become an issue about which I no longer am concerned with in the "Strongly, But Somewhat Impersonally" sense, but rather in the "No, Really, And With Personal Anger And Rage" sense. Because I used to just think it was important on moral and ethical and justice-type grounds, but now I have experienced the nature of life when a one-inch-high step that, walking, I wouldn't even notice, is actually a source of pain, exhausting effort and massive inconvenience, and really, it does make it all a lot more visceral.
I now feel, just a little bit, that anyone who gets pissy about providing proper wheelchair access to things should be provided with an unstable ankle fracture. Once you're a few days past surgery, they're not that painful - most of my pain now is muscle, knee and tendon-related, and a carefully administered break could avoid wrenching everything as badly as my fall did, and also avoid the extra broken bone I collected - and you don't get to walk for months.
I think it would serve as an excellent demonstration injury. Obviously, it doesn't cover anything *like* the full scale of what wheelchair-prompting disability can entail. After all, you can still move pretty well otherwise, and you have one working leg which makes a lot of things much, much easier. For example, I can get up off my wheelchair, using my working leg, and swivel around to get onto a toilet that has no lateral transfer access. I imagine that this is making my life vastly, inexpressably easier than if I couldn't.
Nonetheless, I do feel that it would do much to convey the point.
I was going to go on to the post I want to make about health care systems, but all this has gone on long enough that I think the other one needs to be a separate post. (I always prefer to make posts about Serious Topics separate from personal ones, in case people get linked to them.)
Especially posts in which I have been advocating the deliberate injuring of annoying people.
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Just below this, in the cut tag for this post, there is going to be a warning. I cannot stress enough how much I mean it, so I'm also going to say it in the actual post:
If you are squeamish, particularly about injuries, bruises, cuts, stitches, or anything like that at all, I advise against looking at the photos in this post. At all. Just don't do it, you don't want to see it. I used my phone to take pictures of my broken leg when the cast and stitches were removed, and they are pretty appalling, as far as legs go.
However, if you are not squeamish, and are interested in looking at the effects on the outward appearance of a human leg caused by breaking bones and surgical repair, then click away.
( No really I mean it if you are squeamish do not look at the contents of this cut. I'm serious. Don't. )
I now have another cast, a proper all-the-way-around one with the higher grade of plaster. It's even blue. I keep this cast for a month, and then it gets removed, everything gets checked, and then I get some kind of boot cast that's even removable so I can wash my leg and stuff. In the meantime, I'm to keep my foot elevated, so... yeah, I still live on the couch.
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E-mail of choice for today:
From: Sami
To: Dean
Subject: I have a message from my giant death robot
He wanted me to tell you something...
What was it?
Oh yeah
BOOM
[end]
( Context, if you really must. )
In not unrelated news, I'm not sure using a Giant Death Robot to attack Tokyo will ever not be hilarious.
GAMERA WILL NOT SAVE YOU NOW
Anyway, I've been quiet for the last week or two because, as it turns out, I was in fact very very sick. Sick enough that, when I started to recover, the answer to how I was feeling started with "lucid", because for several days, I really wasn't lucid at all. (Hence this post.) My delirium was odd, because it wasn't based on a fever as far as we could tell. Checking with an actual thermometer even revealed my temperature was up *maybe* half a degree from what I could recall was normal - and definitely not very high, given I didn't even break 37.
In a new category for Weirdest Symptom Ever - that hasn't quite cleared up - this illness also made my teeth hurt. I was, for a bit, mildly worried that I'd developed my first ever cavity or something, and this was actually the proverbial toothache, but then I decided that toothache from tooth decay probably didn't come and go at random points all over one's jaw. I have 29 teeth*. At various points over the last couple of weeks, every single one of them has hurt, singly or in groups.
* - Yes, I know the nominal tooth count for adults is 32. I have 29. Three molars were removed because there wasn't room for them. There's no spare space in my mouth. I don't have the faintest idea where Nature thought three more teeth could fit.
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I just found out how thoroughly my body had taken the "encyst the fucker" approach to my spider bite:
It just fell out.
There's a divot on my hand. Pink scarring below, and a DIVOT on my HAND.
Apparently a small piece of me just got jettisoned.
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