Tuesday, January 31, 2012

LOFT LIFE: The eyes are the windows of the soul - Part one


I was extremely stressed about having cataract surgery.  This began with my initial visit to an ophthalmologist for an exam.
I went there three weeks before my appointment to ask my questions and get them out of the way. They couldn’t answer my questions about fees and costs, but indicated they could find out. So, when I arrived for the appointment, I, in my mind, was merely affirming what I had asked before, and expecting that after three weeks they could answer questions like, “How much does a cataract surgery normally cost?”
I asked, “Can you tell me the normal costs for the surgery?” They answered, “No.” I frowned a bit. Then the two back office people got involved.
“You’re not here for surgery, are you?”
“Well, no.”
“Then you don’t need to know that yet. Please go sit down.”
I was stunned. It seemed like a completely different reception than it had prior to this visit. And, I certainly wouldn’t have wanted me to sit down among the other waiting patients.
I kid you not. It wasn’t, “No, but we can find out;” or “No, but here’s a phone number you can call.” It was, “NO!” 
The exam wasn’t much better. The technician was abrupt and unkind in her attitude. The doctor was all-business and also was not open to even a short inter-active conversation. At the end of the exam, he simply said, “Well, do you want it (surgery) or not?” And when I gulped and said, “Yes,” he handed me a card, told me to make an appointment at his surgical center, and that someone would show me a video and answer my questions then.
I left with knots in my stomach. It felt like a cataract mill. Was this what healthcare will be reduced to in the “new world” of Obamacare, where time isn’t being paid for, so patient care isn’t a priority?
After calling my insurance company, they assured me that this was not a treatment I needed to succumb to, and that I should find another doctor.
I did. 
Dr. E.’s office staff was quite different. They are kind, they remember names, and they go beyond answering questions, to, with patients like me, anticipating what I may want to clarify. They seem to think this is about my best interests. That is comforting.
Even so, my apprehension pre-surgery had reached levels where my husband may have used the words, ‘basket case,’ when referring to me in this time period. I am not sure. I have blocked out most of that month.
I admit it. I was rattled. Really, I like doctors, and usually get along with them very well. I am cooperative, if my questions are answered. In fact, I think some of the questioning is more of a defense mechanism, just to keep some control over my body, my life, when placing myself in the hands of a stranger.
I actually have spent decades of my life promoting doctors and hospitals. So it isn’t a fear of the medical community. They even have a term for when your blood pressure elevates at a doc visit. They call it a “white coat” reaction.
 But, that first ophthalmologist’s office opened my cataract-clouded eyes to the horrifying truth that I am aging, and that old people have less and less say over their care, their choices, and their bodies. One of the psychologists I did some writing for said, “Aging isn’t kid stuff!” 
It’s a downhill slide to losing options. And, though caretakers and practitioners mean well (usually), it is no less stressful for the care-receivers who heretofore have been “in charge” of so many things, people and choices.
I know this isn’t big news to most of you. It is just a fact of life everyone faces eventually--if they live long enough. 
But, I sense that health care is changing for the worse in these areas. It is “hurry up” healthcare these days. There are regulations, and paperwork, warnings, and lawsuits, government mandates,  and, oh so many things to slow things down and take the personal care out of the equation. There is a definite feeling that they must move on to the next patient, and really, they must!
Just listening to the rehearsed speeches, as a doctor goes from room to room, about all of the risks, warnings, and side-effects, is enough to convince that this is no longer a patient-doctor relationship of the Marcus Welby ilk. (Us old people still remember Robert Young’s family doctor character). The doc today has a lot on his mind. He’s lost options also.
So in the face of even reasonable questions, when the day is long, and patients are many, and mandates hang over every doc’s head, they can’t always make reasonable time for reasonable questions. 
After several screenings, tests, a pre-op physical, my surgery was scheduled for December. I was not ready, psychologically, but I had to be ready. It had to be done.
I was apprehensive about the anesthesia, the drugs, having my face frozen, losing consciousness, losing control. 
What if I had to go to the bathroom when the surgery started? What if I coughed. (Some kind acquaintance told me they had a friend who coughed and lost his eye.) What if I vomited?
I had a month to ferment these fears. It wasn’t going to be a very relaxing Thanksgiving season.