Monday, April 6, 2015

Then, I punched an elevator...

          This past Thursday, I punched an elevator. I am not typically prone to violent bursts of anger, but there were many things that led me to be stuck in that hot basement that day, full of minor physical maladies and frustrations. Let’s take a look back, shall we?

           Let’s start with my general experience over the past few years with our current medical system. I am lucky enough to have no major health problems, but rather, it has taken several years to find the root of my relatively minor GI issues. Unfortunately, on the path to ultimately finding out that I have a tomato allergy and something called “abdominal wall pain”, I was re-routed to one urologist, one nephralogist, two gynecologists, two gastroenterologists, and a partridge in a pear tree, because they kept finding things that “might” have been the cause. And each time, there was a co-pay and work time to make up and follow-up visits required. And nearly each visit, I was offered the option of surgery or no surgery and told that it was my decision. (For example, the suggested removal of an asymptomatic kidney stone I have had since age seven; not exactly likely to be the root of my recently formed GI issues).  This surgery as a choice made by the patient thing is a new trend in healthcare apparently. Let’s not even get into the amount of scans and paperwork that don’t get transferred, followed up on, and so forth. 


          So, thankfully, my problems are managed fairly well now sans surgery, but forgive me if my opinion of our overly specialized medical system is not exactly sky-high. In the end, I should be grateful that I am not actually very sick, and I am grateful. I am also one of the lucky ones with good health insurance, and access to some of the best hospitals in the country, but it’s no wonder bills run so high in a business where people are swamped and no one seems to care about efficiency or economy because "insurance will cover that". I have met some wonderful, caring, clinicians and some not so wonderful ones and some great front desk people and some impressively bad ones. Just please keep this in mind as you read about my last few weeks.

          So more recently, I was experiencing a lot of pain in my foot— my second metatarsal to be exact. Years of pronating, (essentially spinning my foot to an extreme point while walking), have done more than just put holes in all my left shoes. The husband has long observed my strange gait: “Yes, you could get orthotics... or you could just learn to walk.” I actually did try to learn to walk in Alexander Technique lessons, and as it turns out, it is surprisingly difficult to walk like a normal person. At any rate, it was in mid-November, when I was onstage in character shoes that I first noticed the pain. But I also ignored the pain, because I had a nerve-wracking, three-hour long German opera to continue performing. By December, the pain was making it difficult to walk and even more difficult to walk downstairs. Apparently podiatry appointments are notoriously hard to come by though. When I looked into seeing a podiatrist in December, I couldn’t get an appointment until February. But you know, it wasn’t like we had a tough winter here in Boston….

          So, two of my appointments were snowed out and I finally limped into the podiatrist’s office in March, where I was diagnosed with osteoarthritis. He McGyver’d a makeshift orthotic insert for me out of medical tape and sent me on my way to check back in in three weeks. Wonderful, swell, pain diminishing. Follow-up appointment booked. Check that off my list.

          In the meantime, I caught a really stellar stomach bug that was making its rounds through my office and I had to leave work in the middle of the day. I managed to time it for my trip home so that I threw up out the door of the cab at a stoplight. One of my finer moments, I must say. I highly recommend this: great for re-living your college days, only with the added humiliation of broad daylight.

          About a week later, I had just finished dinner, and I inexplicably felt very weak. I remember it being weird. The next day, I woke up with an itchy rash on my back that I assumed was a spider bite. The day after that, I woke up and it was bigger, redder, and itchier. So, into the doctor I went, where I was told that I had shingles. So yes, I know I have joked a lot on this blog about how I am actually 85 years old at heart, but now I have ARTHRITIS AND SHINGLES! I am lucky I was able to treat it early, because I did not experience the intense nerve pain that often goes along with shingles. Thanks to an anti-viral, it mostly stayed constantly itchy, unless I scratched it, in which case it also burned. But I’ll take it. Ice packs were very helpful in taking my mind off of it.

          The nurse practitioner who saw me asked if I had been stressed out lately. I told her I’ve been stressed out for about ten years. That very week, I was starting the six performances I had on the docket in the evenings after work and Sunday afternoons. 
(In this same appointment, she thought maybe I should go see an allergist about my nasal allergies, but I told her that seeing another specialist was not going to alleviate my stress at all—far from it.) She suggested that stress plus the stomach bug can often bring on shingles and pointed out that that weakness from a few days earlier was the beginning of my chicken pox's re-emergence. For all you over 60 who are reading this: (I'm talking to my main readership, i.e., friends of my mom), who are procrastinating getting your free shingles shot; DO NOT PASS GO. CALL YOUR DOCTOR IMMEDIATELY AND GET YOUR SHOT! YOU HAVE BEEN WARNED. For those of you under 60, for whom it is not covered by insurance, good luck…

          At any rate, I had full-blown shingles. (Such a weird disease term. Singular or plural? I have been mostly referring to them in the plural: i.e., threatening the husband with rubbing my shingles up against him.) I had my return podiatry appointment, during which I was told my treatment would be custom orthotics from another facility. Instead of making me another makeshift medical tape contraption, I was given a cortisone shot. So there I was, with my hand on my shingles to keep them from itching, getting fluid injected into my foot. It felt not awesome, BUT, the results were pretty baller. Within a day, I was freakin’ Ginger Rogers- I could do anything with that left foot.

          Like a junkie anxiously fearing the end of the current fix, as soon as I could, I made an appointment to get fitted for custom orthotics at the facility closest to my workplace. I asked if I could have an appointment on any day but Fridays so they booked me on that coming Thursday.

          I show up to the orthotics office and the receptionist in the front of the building is gabbing on the phone. I have to wait for her to look up because I can’t find the orthotics office on the directory. This is because it is located on an elevator bank that goes to the basement. She tells me there are no stairs for the basement.

          I walk out of the elevator to the basement to find that it’s approximately 100 degrees there, likely because it’s right next to the furnace. I enter the orthotics office and it is more comfortable. I introduce myself to that receptionist. She takes what feels like five minutes to find my name and appointment and asks me my name no less than three times, interjected with “Are you sure you have an appointment today?” She finally finds it. I tell her I don’t have my prescription in hand, but that my husband scanned it to my email, at which point she tells me she doesn’t know her email address… I should have gone back to work at this point…

          We experiment with different variations on her name and the office domain and she eventually successfully receives my email. Mind you, they’d already told me the orthotics are not covered and will cost me between 300 and 450 dollars, soooo not sure why they need the prescription that badly when they have my health insurance card. But I am told I couldn’t be seen without it.

          The specialist I see in my appointment is great. The prescription from the podiatrist apparently isn’t even very clear and I am able to fill in holes for her. Without prompting, she sympathizes with all the rigmarole patients have to go through, bouncing between doctors and assures me that my custom orthotics would be in in three weeks and that they would work well for a pain management plan.

          I go to check out with a receptionist at a different desk within the office and remind her that any day but Friday would be good for me for my three week follow-up appointment. She tells me that my specialist only works Fridays and that that day had been an exception. They prefer that you see the same specialist consistently.  Awesome.

          Then, I leave to hustle back to my office and here’s when shit really goes down. After ten minutes of waiting in a 100 degree basement, there is still no elevator to arrive. I check the door marked “emergency exit”, which leads me to a weird storage room full of industrial vacuums that I am afraid of getting locked into. I walk back in to visit my receptionist friend who did not know her own email and she exclaims; “You’re still here?!” “Yes,” I said “because I am still waiting for an elevator. Are there really no stairs here?” She says no, there are no stairs. I ask if I can go out the emergency exit and she says she doesn't know where it leads. She walks out with me to the elevator and sees that the elevator light is still lit but nothing has happened yet. She does this super helpful thing of trying to hit the button again, as though that hasn't occurred to me yet... I ask her to please call the front desk at which point she says SHE DOES NOT KNOW THE NUMBER FOR THE FRONT DESK. She is totally unashamed and unapologetic about this. She then answers a call and doesn't put the person on hold or show any other kind of urgency.  I mean, what if there had been a fire or actual emergency?

          I walk out to the boiling elevator lobby again. The “up” button is still green and still no elevator. I wait some more. I walk back into reception, all the while anxiously keeping an ear out should the elevator door open, and this time, the receptionist isn’t even there. It is at this point, at my own boiling point, that I consider creating an enormous scene in front of the three total people in the office, a scathing rant about her gross incompetence, demanding that she find a front desk or security number. And trust me, I am an opera singer. I can scream if I want to... loudly. I take a moment to think of myself as an innocent bystander in that office and instead, walk out into that lobby and slam the side of my fist into that elevator door. Then, I kick it... hard... twice. 
It has now been 17 minutes since I first attempted to leave their office via elevator. I had been jerked around by the American healthcare system for too long. I was hot, late for work, and pissed as all hell. So that, you see, is how one finds oneself punching an elevator. Fortunately, I am neither strong, nor accustomed to punching things, so I only bruised my hand instead of breaking it. That could have been bad because it may have resulted in another specialist appointment.

          About three minutes after my tirade, which I honestly hope was caught on security camera, an elevator finally showed up. As I walked out through the main entrance, the gabbing receptionist in the main lobby was nowhere to be found to even hear my complaints or suggestions. Perhaps this was for the best…