And a Happy New year!

I started blogging last January, and I have lasted a year—although I got very soft and weak after about six months.  But I must start again strong in the new year—after which I might get soft and weak after about six months.

I have a list of things I’m planning to write about.  They might interest a few people.  They might not.

But please don’t stop coming by.

And:  have a happy new year!

jj

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MERRY CHRISTMAS!

One and all.

I’m a bit surprised at the lack of Christmas blogging.  You don’t have to write anything:  you just have to wish everyone a merry Christmas.

So:  Merry Christmas!

jj

Wounded in Gettysburg…part 4

So I get back to Germany safely. I did not have a heart attack during the journey, in spite of a horrific flight from Harrisburg to Philadelphia—during which we experienced turbulence bad enough to scare Chuck Yeager.

I get home on Saturday. First thing Monday I go to my doctor to get my stitches out. The hospital has given me copies of all the test results, including the EKGs. I tell my doctor the story (which is not quite as easy to tell in German, because I obviously don’t know how to say “vasovagal syncope” in German. Of course, since “vasovagal syncope” is some kind of Greek-Latin mix—and not English—he understood it just the same. He just pronounced it differently. ).

I show him the EKG.

He says something like, “Oh, that’s nothing.”

But then he tells me that when he interned in the hospital, he was taught:  once you suspect a possible heart attack, don’t release the patient until you have fully eliminated the possibility that it’s a heart attack.

Which means, I suppose, that the doctors did the right thing.

Maybe.

The question is: was it reasonable to suspect that I might be having a heart attack?

The Friday after I returned I went to the monthly meeting of a group of Americans where I live. My American friend Tom is a doctor, so I asked him about PVCs. He said something like, “Hey, I always tell people: having an extra heartbeat is better than not having a heartbeat.” From his perspective, that I—having just passed out in a bar and conked my head good enough to require four stitches, in a strange town during a holiday visit, with jet lag and having not eaten all day—should have PVCs on my EKG was absolutely nothing to be concerned about.

(I should also say at this point that my sister the nurse had also expressed a bit of curiosity that PVCs on my EKG should have caused so much concern.)

So, to wind up the story: I kip over and bonk my head in a bar in Gettysburg. They send for an ambulance to drive me less than a mile down the street at a cost of almost 400 bucks. The doctor sees PVCs on my EKG and fears I might be having a heart attack, so he orders a couple thousand dollars worth of tests and a $2000 overnight stay in the cardiac ward.

And I have blood and urine tests proving that—regardless of comments to the contrary—I was not high, either from drugs or alcohol. Just an innocent tourist in Gettysburg, who didn’t take well to Troegs beer. And who missed the “#16 Char-Grilled Steak Sandwich” at the Springhouse Tavern, which is what I would have ordered had I felt well and not slammed my head on the cold stone floor.

Which is what Robert E. Lee would have ordered as well.

jj

Wounded in Gettysburg…part 3

Here’s the bill:

First, the ambulance ride:

Ambulance Base Charge – BLS $365

BLS Mileage Charge $8

Total: $373

Then the hospital bill, skipping the stuff which says $0.00:

CCU – Ancillary 203.17

Pharmacy 66.00

Pharmacy – IV solutions 52.00

Respiratory Therapy 163.25

Radiology – Xray 438.50

Radiology – CT Scan 868.25

LAB – Chemistry 685.50

LAB – TDM/TOX 98.50

LAB – Chem Immunology 111.25

LAB – Hematology 95.50
LAB – Toxicology 185.50

LAB – AML Phlebotomy 24.50

Cardiology 2143.00

Uninsured discount -256.69

Amount Due 4878.23

This bill is so much fun I could blog the rest of my life about it. I should begin by saying that I received two bills: the one I just typed and an itemized bill, listing all the specific drugs and tests. For example, I was charged $13 for four chewable 81 MG aspirin, presumably to thin my blood a bit in case I was having a heart attack. Now, I suppose my sister might jump in and comment about why these aspirin are so expensive, but my own reaction is that it is obscene to charge $13. That’s over $3 per tablet. A quick googling shows a three pack of36 of the exact same aspirin at Amazon.com for $18.17, which comes to about 17 cents per tablet. Thats roughly a mark-up of 1,800%.

But then, the nurses have to be paid to bring the little tablets in a little paper cup and call me “Jeff”.

The other thing which strikes me about the bill is that nowhere else—literally, nowhere else in the world—do they have so much freedom to charge you for things without asking. It’s like going to a restaurant where they charge you every time they stop by to ask, “Is everything okay here, guys?”, and charging you fifty or sixty bucks to do it.

I told the doctors explicitly: if you are afraid I’m in danger of dying or something, do your tests. Otherwise, whatever can wait until I get home should wait until I get home, where I know I’m covered by the insurance.

Let me tell you about German health insurance. The monthly fee may not be cheap (although it’s fair, being based solely on your income), but being covered means being covered. I must pay a 10 Euro quarterly fee to actually see a doctor or go to the hospital, and if I stay in the hospital I must pay a minimal fee for the bed (something like 10 Euros a day), but everything else—every test, every operation, every band-aid, every pill, EVERYTHING—is covered. So if I go to the hospital, I pay the daily fee and the quarterly fee (if I haven’t already paid it), and everything else is paid for by my insurance.

In other words, had this entire incident happened in Germany, the cost would have been: 1., the quarterly fee of 10 Euros, since I hadn’t been to the docter in the last few months; 2., the bed fee of around 10 Euros.

20 Euros for a night in the hospital.

Incidently, children don’t pay anything at all.

So in America, these doctors can start running up charges like mad, and I as a patient do not have anything to say about it (well, I said something, but they didn’t listen), and run up a bill. In fact, I would assume that, given the culture of malpractice insurance, they are encouraged to do it for medical reasons.

But if a car mechanic did the same thing (Oh, your brake pads are worn and you need an engine analysis and a new computerized muffler belt bla bla bla) that the doctors in Gettysburg did, they would probably end up in jail.

Except for: they might have been saving my life.

And I appreciate that.

But…golly…I pass out in a bar and they decide to stick an oxygen tube in my nose and charge me $163.25 for oxygen? I was breathing fine!

Next up, what my doctor (and doctor friend) have said about the whole experience.

jj

Wounded in Gettysburg…part 2

So I’m in the ambulance. First, I’m surprised to be sitting on a simple chair belted to the floor, with no seatbelt, and with a rather cute woman tending to my wound. I’m surprised not only at the lack of a seatbelt, but at the amount of empty space around me. Basically I’m sitting on a chair in the middle of the back of an empty van. I had always thought that the back of an ambulance is crammed with equipment. So much for Emergency.

The cute woman asks me to repeat what happened. I had already told—with her present—the whole story to her partner. But I would repeat the story at least ten times within the next 18 hours (and I’m not exagerating). She also called me “Jeff”.

In no time we arrive at the hospital. It must have been no further away than a couple of city blocks. They accompany me into the building (I’m walking) and I go to the receptionist, who asks me to repeat the story. At no point does she ask me for any identification, which I find odd. Then I begin the first of at least five conversations regarding my health insurance.

I’m insured, of course, because German law requires everyone to be insured. But my particular status—being insured by a foreign insurance company—seems a bit complicated to the poor woman.

(This I found somewhat surprising. Gettysburg is one of those towns in which on any given day the tourists probably outnumber the residents. I discussed this later with my sister, and argued that perhaps Gettysburg is only a draw for American tourists, and that probably not so many foreign tourists go there. She assured me of having seen many a busload of foreigners in Gettysburg.)

At some point I get put into a bed. A nurse comes, and asks me to repeat the story. I do. She takes my blood pressure.

A doctor comes, and asks me to repeat the story. He orders a bunch of tests: a CAT scan of my head, an X-ray of head and neck, an EKG, and blood and urine samples. They start with the EKG.

Five minutes later, the doctor comes again and asks, “Do you have any chest pains? Did you have any chest pains?”

“No.”

“No chest pains?”

“No. Ummm…why? Is something wrong with my EKG?”

“Well, I’m not really sure. There are some [doctor speak which I don’t recall] which are somewhat unusual. Let me get it and show you.”

He shows me what I later learned are called PVCs.  Remember this.
He talks quietly to the nurse, and things start to change quickly. They put an IV in my hand, an oxygen tube thingy around my ears which blows air into my nostrils, a blood pressure band around my arm which is hooked up to a machine that automatically takes my blood pressure every few minutes, a red-glowing white plastic thingy on my finger, and electrodes on my chest. I also have to get undressed and put on a hospital gown.

Meanwhile, all the nurses call me “Jeff”.

At this point I’m thinking, “They think I’m having a heart attack!” which upsets me a great deal. I almost start crying. I’m in Gettysburg having a heart attack, and I’m supposed to fly home in two days!

They tell me that they’re monitoring me closely, and that if necessary they will move me to a hospital in York.

The doctor orders more tests: chiefly, he wants an X-ray of my chest now.

They start doing all the tests. Meanwhile, I’m feeling better than I’ve felt all day. I’ve calmed down, because I’m convinced I’m NOT having a heart attack. As for the PVCs, I’m thinking that maybe that’s exactly what they saw the last time I had an EKG back in the early 80s, which the doctors said showed “an irregular heart beat” and wasn’t anything to worry about. I tell the nurses and doctors this, but they seem to ignore it. Maybe it wasn’t relevant. What do I know? I’m not a doctor.

Eventually I get put into a bed up in the “Critical” ward. I get a room by myself.

I’m told not to urinate in the toilet, because they want to measure my urine. Right. I’m tied to about six machines, and I’m just going to hop out of bed and go to the toilet all by myself, wasting perfectly measurable urine.

They start a bunch of paperwork. I get several nice brochures: my rights as a patient, something about managing my pain (which I’m supposed to put on a scale from one to ten), something about the Gettysburg hospital. Their main concern seems to be my “valuables”. Luckily, for some superbly strange reason, I wasn’t wearing my ring or my watch. I ALWAYS wear my ring and my watch, even when sleeping. Apparently I had forgotten to put them on after taking a bath. So all I have is my wallet. They ask if I want to put it in the safe. I say, “Don’t worry about it.” They say it’s no trouble, really. They seem to want me to want it locked up. So I say okay, and we fill out another form with the contents of my wallet. I have euros in addition to dollars, which seems to throw them for a moment. They put the wallet in sealed bag.

It is now about 1:00 AM.  I’ve been here since…oh…around 6:30 or a quarter to seven.

They tell me to try to get some sleep, which I manage to do, but only in fifteen minute increments. Because every fifteen minutes my blood pressure is automatically taken by the damn machine, which also seems to pump it up much tighter than the average nurse does. I also can’t roll to the side with the blood pressure arm band, which means I can only lay on my back or right side.

But I do sleep some, until they start doing more tests in the morning.  New nurses start the day shift as well. So I get to repeat the story a couple more times.  And new strangers call me “Jeff”.

The tests are an ultrasound of my heart and an EEG. The EEG requires me to have about twenty electrodes stuck to my head with something like greasy rubber cement. And I’m supposed to be still for most of it, though at one point I start to fall asleep and kick my legs out a little, which gets me a mild scolding.

But she calls me “Jeff.” Everyone in the hospital calls me “Jeff.” I think it must be hospital policy to use first names. I find it mildly unsettling, just like the constant stream of “excuse me”s at Target.

Breakfast comes: three small blueberry pancakes with syrup, orange juice, and milk. I eat three bites of the pancakes without the syrup and drink the orange juice.

The doctor comes. He sits on the edge of the bed and talks to me for a long time—ten minutes or so. He says he doesn’t think I’m having a heart attack. He also doesn’t think I was having a seizure, though my sister claims I stared into space for thirty seconds or so before hitting the floor, and that I was out for a good minute or two. He gives the diagnosis of “Vasovagal Syncope”. He says I can leave soon.

Lunch comes: canned green beans, a small potato still in its jacket, and a small chicken breast rolled in herbs. This is obviously part of the diet for a heart patient. There is also a small paper cup of ice cream. I eat the chicken and the green beans, two bites of the potato, and leave the rest for the nurses.

They release me around noon. I have been in the hospital for about 18 hours, because I passed out at a bar.

Next…the bill.

jj

Wounded in Gettysburg…part 1

It is time, my friends, to tell you about my trials in Gettysburg. I have only been waiting for the hospital bill, which I have just received, and am now ready to tell my story.

Wednesday, November 29, the week after Thanksgiving. I’m in Pennsylvania visiting my sister. I have eaten like a pig and have drunk like an Irish sailor. My sister and her best friend want to take me to Gettysburg for a nice evening here: Springhouse Tavern.

I have spent the day feeling slightly nauseated, so I have done nothing but watch TV. I have eaten nothing.

On the drive to Gettysburg, my sister’s friend mentions the bad suspension on the pick-up we’re riding in. I say don’t worry about it, thinking my nausea has mostly to do with the excess of alcohol and the lack of food I’ve had during the last few days. But the truth is that I’m thinking, “I have no appetite. In fact, I’m nauseated. I’m not going to enjoy this evening.” Little did I know.

We arrive and go into the tavern and sit at the bar. I’m not feeling good, so I’m thinking, “get a quick little buzz and you’ll feel better.” I’m also thinking, “whiskey isn’t the best thing when you’re nauseated.” So when my sister’s friend orders a gin and tonic, I do the same, thinking it’s a good way to quickly get some hard liquor into my system without punishing my nauseated stomach.

I kick it back within about five minutes or so. Doesn’t make me feel any better, doesn’t make me feel any worse.

Time for another round. I order a beer. Well, not quite. If you order a beer in Germany, they bring you a beer (the house brand). If you order a beer in America, they want to know which beer. I say, “Whattya got on tap?” They say, “bla bla bla bla bla”. But one of the beers on tap is a local beer. No, not local, excuse me. A “regional” beer from Harrisburg. At the time, I’m forgetting I’m in Gettysburg, so Harrisburg sounds local to me, so I order the Harrisburg beer. It was (I think) this: Troegs. Well, it was Troegs of some sort or another.

I did not like it, Sam I am. I did not like it at all. In fact, I wondered if my taste buds were out of whack, because I cannot remember a beer I liked less.

So I’m sitting on the bar stool, nursing a beer I don’t like at all, having a conversation with my sister and her friend, thinking about how I don’t feel right.

I finish the beer, and order a Sam Adams. I’m thinking that the Sam Adams is a good test: I know how it tastes, so I can tell if my taste buds are in order. It comes, it tastes like Sam Adams, my taste buds are in order (I just do not like Troegs), and I’m fine.

Except for I’m not. I’m feeling chilled and nauseated and slightly dizzy. Furthermore, I’m starting to get a cold sweat. I mention it. A conversation begins regarding my possible hypocondria. Well, I have definite tendencies in that direction, but so what?

I take a second swig of my Sam Adams. Up to this point, I have had a single gin and tonic and maybe 14 ounzes or so of beer. But I’m sweating like mad, feeling chilled, and getting so dizzy I’m afraid I’m going to faint.

I say, “um…I’m not feeling well”. Later I say, “I’ve got to get out of here…” My sister suggests I go out and lay in her pick-up. Good effin idea, because I’m swirling with dizziness and nausea.

I stand up.

At this point, we have to depend on the story of the witnesses. Apparently, I stand up but put my head down on the bar and stare off into nowhere. My sister says, “Jeff, can you see me?” To which I answer yes. Her friend goes over to me and grabs the back of my belt to keep me upright. But at one point I tip over, and he can’t keep 180 pounds from defying gravity on such short notice, and I hit the ground. Face first.

I don’t remember any of this. The last thing I remember is thinking, “I’m going out to the pick-up” and standing up.

I wake up on the floor of the tavern. People are saying, “just relax and be still, the ambulance is coming” and my sister’s friend is putting my feet up and someone else is handing me a paper napkin because I’m bleeding like mad and there is a pool of blood next to my head. You get the picture.

But I’m feeling MUCH better. Really. The nausea has subsided, and the cold sweats and dizziness are gone. I’m lucid and thinking about finishing my beer.

Nevertheless, the ambulance people arrive and ask me what happened and all that stuff. Of course, they had already asked everyone else what had happened.  (One thing I learned from this experience is that you have to tell “what happened” to every single medical person you come in contact with—including my other sister, who is a nurse.) I’m feeling better so I say so, but everyone still thinks I should go to the hospital, if for no other reason than to see if I need stitches for the gash in my head.  Remember this.

So…off to Gettysburg hospital.

For my stay in the hospital, read part 2

jj

Blogging Culture

Yesterday I was a bit bored. I had read my usual blogs and websites, had my fill of pornography, and didn’t want to leave my computer. So I got the idea of clicking the random blog button on my WordPress control panel.

I looked at maybe fifty or sixty blogs yesterday. Maybe more.

Two things struck me in particular:

1). The vast majority of bloggers (okay, a sample of fifty or sixty doesn’t mean much in the real statistical world) blog very irregularly—even less than I do. This was good information for my bad conscience. Most, as I did, start hot and then cool down with two or three months. This makes perfect sense, of course, since anyone who blogs knows how strange blogging is. You begin a blog thinking more or less of it as a diary, but later become interested in the number of readers, and lastly become disappointed that so few people are reading your blog, and quit (or think of quitting). A strange, strange thing. If you begin a blog thinking “no one’s going to read this”, then why do you later become disappointed that no one is reading it? Human nature is a strange thing.

2). I also noticed a LARGE number of religious blogs. Some seem to be nothing more than an organizational meeting place for Bible studies; others are personal accounts of their spiritual journeys. But there are a lot of them. And of my personal random sampling, the vast majority were Christian. Which got me to thinking: “WordPress”? Does the very name “WordPress” attract Christian bloggers?

Of course, I can only read English and German, and I ran into several blogs in languages I could not read. It could very well be that there are a lot of Hindu blogs, for example, but written in Hindi; so my observation that there are a disproportionate number of Christian blogs could be way off the mark.

jj