Tuesday, January 30, 2007

A Medical Miracle

So, today I experienced a miracle. No, really. It was, by Canadian standards, unequivocally, a miraculous experience...

Last night, I woke up in the middle of the night, and immediately realized that something was not quite right. A trip to the loo (my darling) confirmed that I was in the early stages of a UTI (i.e., urinary tract infection, for those of you lucky enough to not know about such acronyms). Not to panic, I quickly located my well-expired, just-in-case prescription for dealing with such a malady. My prescription is so expired, in fact, that it is no longer possible to read the label as it has worn off the bottle. I only know its contents because of the ridiculous lie I had to tell a Doctor in Ontario about 2 years ago in order to get it, and because I carry it with me. Everywhere.

You're wondering why? Good question.

I have had 3 UTIs in my life. This is the 4th. I acquired this prescription after my 3rd UTI with the self-preservatory intention of avoiding what I had just gone through in treating my 3rd UTI.

Which is how I found myself, about two years ago on a Saturday afternoon, talking my way into a medical clinic that was trying to close its doors for the weekend (note: this is the ONLY time it would be possible to pull a clinic scam, because the employees just want to get out of their disease-ridden workplace).

Once inside, I lied to the clinician about my symptoms. I begged them to allow me to see a doctor. They told me they were closing and the doctor was leaving. I assured them that I would NEVER impose on the medical system in this way, but that it was an emergency. I lied.

They asked me for a urine sample, which I provided and asked me to wait for the Doctor. The Doctor who saw me wearing her coat and holding her purse, told me that my sample hadn't revealed any trace of an infection. I told her that I had just drank a MASSIVE amount of water and suggested that it might have diluted my sample to undetectable levels (I read on the internet that this was possible). I then proceeded to describe, in detail, the symptoms of my last UTI and made it generally clear that noone was about to start their weekend any time soon. And then the clincher -- I looked her straight in the eye and told her I was 4 hours from getting onto a flight to Europe and that she was my only hope.

Reluctantly she wrote me a prescription which I got filled and which, until today, I carried with me whenever I was away from my house for more than a day.

So, ok, why was all this deception necessary? Am I a hypochondriac? I don't think I am.

Anyone who has had a UTI knows how intensely painful they get, and how quickly the pain sets in. One moment you're like "hmmm... something's not quite right here" and the next it's like you're auditioning for a catholic heavy metal band, hollering "Holy Sweet Mother of GOD"!! in your WC. And then it just keeps getting worse, and worse. Until you take medicine for it, which, in Canada, has personally taken me up to 8 hours to obtain via the 'normal' channels.

In Canada, this is my personal experience of the normal way to obtain after-hours treatment for an excruciatingly painful UT infection:

You wake up at 3:00am in terrible pain. You run to the washroom where you will spend the next hour or so. You grab the phonebook and dial the number for the Dial-a-Nurse-in-NorthBay.

Dial-a-Nurse is the government's way of trying to keep people out of the emergency rooms.

How it works is, you describe your symptoms to a nurse located "somewhere in Ontario" who tells you that, if you feel worse in an hour, to go to the emergency room -- and then she gives you a case number.

You wait in your bathroom for about 20 minutes. Things get worse.

You drive to Emergency, find a parking space 1/4km away from the entrance, and run into the building. Running past the intake nurse and the mashed up roomful of broken legs, bloody faces, drunks, and concerned-looking elderly spouses in their pj's, you beeline for the filthy bathroom, sending up a prayer that it is unoccupied because you are quite prepared to pull the fracking handle off the fracking door and bodyslam any occupant off of the toilet. You are so grateful that it's empty that you fail to be judgmental about how unclean it is.

5 minutes later, you enter a line to wait your turn to see the intake nurse. You are behind a suspected heart attack and an insulin reaction. Behind you, in the wating room, children are whimpering or screaming, old people are moaning, and a drunk teenager is holding a bloody rag to his nose and scowling angrily at everyone in the room. The only 2 available seats are on his immediate right and immediate left. Several people are standing, leaning miserably against the wall. You know it is going to be a long night.

It's finally your turn to see the intake nurse. You tell her that you really have to pee again. She looks at you, sort of, shrugs and says "well, you can go to the bathroom, but you are going to have to wait in line again". Seeing how this could end up in an endless loop, you resolve to ignore the painful pressure and the certainty that you are seconds away from peeing yourself in the intake chair. You remain seated and answer her questions, producing your health card, and correcting her spelling as she enters your particulars into the system. She hands you a hospital card and tells you to take a seat and wait to be called. You ask how long she thinks it might be. You tell her that you are in quite a lot of pain and just need to see the doctor for 5 minutes to get a prescription. She is already busy with other paperwork and doesn't look at you as she shrugs and says "It's Friday night. Could be a few hours".

You have no options. You wait in the waiting room with everyone else.

For the next 5 hours, you alternate between getting up to pee and sitting in a hard molded plastic chair amongst the diseased and disordered. Everyone is in pain, or comforting someone else who is. Everyone is completely miserable. You don't think your pain could get any worse, but it does. Each time you get up to pee (which is every 5 or 6 minutes), you are certain that your name has been called and you have been overlooked. But you have no options but to keep getting up to pee and then to pester the intake nurse every hour or so who assures you that your name hasn't been called and that it probably won't be for quite a while.

Over the hours, a slow parade of the people who arrived before you march one-by-one past your chair as their names are called at painfully long intervals. Soon the waiting room contains mostly new broken faces and you start to allow yourself to believe that it might soon be your turn.

Finally, your name is called. You are brought into an examining room consisting of a bed & a cabinet that is surrounded by a sheet. A nurse asks you the same questions you were asked during intake, makes a few hurried notes on your chart, and tells you to take a seat in the 2nd waiting room. The doctor, she says, will be right with you.

In a Canadian emergency room "right with you" means "within 3 hours". Which is how long I sat in the second waiting room.

The 'second waiting room' was a chilly, dimly lit corner of a hallway with 6 plastic cafeteria chairs. In Canada the hospitals are purposefully kept at very low temperatures in order to keep the bacteria that is covering everything from multiplying too rapidly and killing everyone. The waiting room also had a broken brown table that was strewn with the standard array of magazines from the previous decade. Want a life-saving tip? NEVER touch the magazines in hospital waiting rooms. Over time these ancient texts are thumbed through by people with every disease known to man. And NEVER let your kids touch or play with the toys if there are any. EVER.

This hallway waiting room was also used as an overflow area for patients. Canadian emergency wards are always overfull, and there is no place to put the excess patients. The truly unfortunate are simply wheeled into hallways and left there. As I waited these next three hours, a nurse wheeled in a guerney that held someone's Grandmother. This frail, elderly woman lay underneath a thin blanket that she barely made a bump in. She began whimpering and ocassionally called out for a nurse to help her. Many nurses rushed past her, but none seemed to hear her. None stopped. A couple of times she tried reaching for them, but she was too weak. Too invisible. The nurses were too busy. She started crying. She said to noone that she was cold. She called out hoarsly that she was in pain. I went to the desk and asked a nurse to bring her a blanket. She said she would when she had time. I offered to bring one over to her. She looked at me levelly and said 'I will bring one when I have time. Please take your seat'.

And finally I saw the Doctor.

He asked me the same questions about my symptoms which I answered and which now included 'a lot of blood in my urine' and 'the inability to stand up straight'. He touched my lower back and informed me that the infection had advanced into both of my kidneys. He wrote me a prescription, got up and left without saying anything else.

Our entire interaction lasted less than 3 minutes.

When I walked past the old woman on the guerney, she was sleeping in the hallway where she had been left. The nurse still hadn't found time to bring her a blanket. I was happy she wasn't crying anymore.

I paid the hospital parking attendant about $20, drove to a pharmacy and got my prescription filled, which was another $20 or $25.

And that is why the next weekend, I drove to a clinic and lied in order to get a spare prescription. And that's why I was fully prepared this morning to take expired medication.

So about the miracle...

By contrast to my experience in Canada, I have just experienced the normal way in Belgium to obtain after-hours treatment for a UT infection. It goes something like this:

You wake up in pain just before 3:00am and think 'something isn't right', and immediately panic at the memory of the last UTI that comes flooding back. Prepared to start eating handfuls of the well-expired medication that smart-girl-you are immensely grateful to have, you decide to first see if there might be another option.

You find a flyer with the name of a doctor who is open all night and you phone her, doubtfully. The Doctor answers the call herself and tells you to come over. It is 3:07am. You drive 4 minutes to what looks like her house and she buzzes you inside. There is noone else in the waiting room.

You start to suspect that the UTI had actually killed you some hours ago and you are now entering Heaven's foyer.

The Doctor greets you with a handshake, shows you into her examination room (which is very clean) and asks you to describe your symptoms. She confirms that you have a UTI, writes you a prescription and directs you to the all-night pharmacy which is all the way on the other side of the intersection. She charges you 21Euros which your work will reimburse you for. The pharmacy takes less than 2 minutes to fill your prescription and charges you 1.86Euros which your company will also reimburse you for.

You arrive back home and take your first tablet standing in your kitchen. As you swallow it, you glance at the clock and note that the time is exactly 3:36. Less than 45 minutes have passed since you woke up.

You take the expired prescription out of your purse and dump it in the trash.

Closing the lid, you send up an apology for every bad thing you have ever said or thought about Belgium.

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Blogger That's so pants said...

Welcome back Penless. I believe that excellent health care is a European claim to fame. Unfortunately, Britain is not THAT European yet so I can't afford to get sick. Looking forward to the return of Andre.

9:20 p.m.  
Blogger Jenni said...

MD247 doctors and telemedicine program members are legitimately given the opportunity to connect, allowing a patient the chance to talk to a doctor without that doctor worrying about time and overhead.

Talk to Doctor

2:33 p.m.  

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