Bowel Obstruction #10

    Preface: Imagine a line stretching from left to right in front of you. Look at the right end of the line and imagine that the people who believe in the freedom of the individual are there. Then look at the left end of the line and imagine that the people who believe in the complete coercion of the individual by government employees ( they always live off the people [plural for the individual]). That line is a spectrum, and that is how I would like "rightists" and "leftists" defined. Otherwise, the line becomes a circle because as currently understood "far rightists" meet "far leftists" because they both believe in the complete coercion of the individual by government employees. It is where the fascist Mussolini meets the Communist butcher Stalin.
    Saturday, 4-30-2016: The woman who claims to be Alene Peterson and to have sent me an anonymous letter firing me from the practice at Brattleboro Internal Medicine also comments about my new primary physician-to-be. She says she and I are "a good fit." I would have asked what that meant since supposed-Peterson's voice was still steely and hardly friendly. However, I am standing in the Hannaford parking lot with cars and people going by, so I don't follow up that tantalizing comment."How come the practitioner and I would be a good fit since you just threw me under the bus?"
    The lady now claiming authorship of the anonymous letter also asks me if I want to keep my upcoming appointment with PA Paul. I tell her that the crisis seem to be resolving itself ( I had my first normal movement in two months, but I wasn't going to get into such details with her). I tell her I feel safe in relinquishing the appointment with PA Paul. I also know from his last call to me, that I no longer trust him. Obviously, after he read the post that I left for him at his office - and he probably read the rest and is still reading the posts- he doesn't particularly care for me. Supposed_Peterson had said he didn't want to work with me. It would be a waste of time, at the very least, for him to try to provide medical services for me. Even an emergency would better be handled at the emergency room especially since I would be seen by a medical
doctor- an MD. I just notice that illegal aliens going free to our emergency rooms get better care than I do on Medicare based on my age than I do as I get physician assistants not MDs! That's nice.
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary
   

Bowel Obstruction #9

    This morning at my urologist's office my blood pressure was 140 over 100 in spite of taking two different blood pressure pills. But I would rather stroke out fighting than to live a long life of passivity toward things I believe are wrong.
    That segues to receiving a call from a person calling herself "Alene" (not sure if I heard her correctly) Peterson, and she claims to be the writer who fired me as a patient of Brattleboro Internal Medicine. I get the call as I'm walking through the Hannaford parking lot. Do you know the place? It' got one of the world's shortest green lights to get into and out of the parking lot. Only two cars can take a left onto Putney Road during one green light, and then the light turns yellow. Vehicles have to roar out of there so the vehicles piled up behind them have a chance to get out of the parking lot that day. It's a ticket or an accident waiting to happen. Are the city employees mad at Hannaford and are trying to make going there difficult? Returning to Ms. Peterson who, for all I know, is not Ms. Peterson since I have never seen or talked to the real Ms. Peterson though she fired me as a patient. Jody Dodge, administrator at Brattleboro Memorial Hospital had told me about a week or so ago that she had walked over to Internal Medicine to talk to an administrator there named Alene Peterson about me getting the results of my X-rays and to get my Paxil prescription transmitted to Walmart (that horrible "big box" innovation that saves the average family about $1,200 a year). Jody said I could expect calls from PA Paul, Nava, I think her name was, the prescription transmitter, and Alene Peterson, the administrator. I got constructive calls from Paul and Nava, but Ms. Peterson didn't call.
    Now that Ms. Peterson was calling, I immediately asked in the Hannaford parking lot with the world's shortest green light why she had not signed her letter or even identified who was writing the letter that dismissed me as a patient. In a steely voice, she replied that it was standard operating procedure at Brattleboro Internal Medicine "and other places too." I replied that I had never seen such a letter, but I had only been a social services director, so what did I know.
    Her response was that maybe in some states things are done differently. Was she implying that in Vermont businesses that fire you don't identify themselves?
"Guess what, honey. I got fired today, but the person who fired me didn't sign the letter or even give me his name. I guess God must have done it or someone who thinks he is."
    Later, I check with several old-time Vermonters, and they had never seen such a thing.
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary

Bowel Obstruction #8

    Monday, 4-25-2016: I got a call from PA Paul and explained that I was worried about being on only Benazapril to see if the Norvasc was causing the constipation since I had broken through the Benazapril by itself and even broken through both Benazapril and Norvasc when I went to the emergency room. At that time, my blood pressure was 150 and the alarm on the BP machine went off. Paul said he could prescribe another blood pressure medication, but it could introduce additional factors. I reiterated I was worried about stroking out. He reiterated that he wasn't saying we wouldn't use another blood pressure medication, but I could withstand a blood pressure of 160 over 100 for several hours. I thought we were on a merry-go-round so I suggested that I split up the 60 milligrams of Paxil I take one time a day to taking it two times a day to see if it were the Paxil causing constipation. He agreed with that, and I said I'd call him back in a few days to report. He said okay, and I remember ending with "Thanks a lot, man." I felt good, thinking that the train of excellent and prompt medical care and friendly, even warm, relations with the staff at Brattleboro Internal Medicine was back on track, only being derailed a short time. Boy, was I wrong! Apparently, a distant command and control type administrator who wasn't keeping up with events - a common phenomenon in centralized command and control operations- decided to throw me out to the street by way of a registered letter I had to sign for. I will assert my views about this letter in another post, but let me say it was very unprofessional and discourteous and cowardly as there was no author or authoress to the letter nor did she sign it. I hope this is a man as I have found that men can clash antlers, not cry about it, and not run for victim status, and then get along fine afterwards. I'm not so sanguine about a woman. My substantial years in this world don't support such optimism. I guess that will inflame those who think there are no differences between men and women. I would certainly agree that the differences seem to be diminishing each year until I find myself wondering if it's going to end up with women only protecting us from the swordsmen of the Islamic State Caliphate. I can't help but notice the athletic, young women striding along in their boots and tights with their chests out accompanied by schmucks padding along in flip-flops, skinny legs in short pants, and no chests.
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary
   

Bowel Obstruction #7

Thursday, April 21, 2016 12:08 pm: Nurse Mark calls back from Brattleboro (Vermont) Internal Medicine and leaves a message. He says PA Paul wants me to stop taking the new blood pressure medication, Amiodipine Besylate (AB for our purposes) for 1 to 7 days to stop the constipation. He wants me to buy a blood pressure cuff and use it. If the blood pressure gets 150, I should call Paul. Paul also wants me to resume taking AB after the constipation ends because it's so good for me.
    I call Nurse Mark Thursday morning at 10:30 and leave a message. I ask if it is safe for me to be only on one blood pressure pill as it doesn't work anymore. I also ask if I get a 150 on my  blood pressure, is it safe for me to wait hours for Mark to get my message, get to Paul, and then get back to me? I remind him that about a week ago at the Emergency Room in spite of both blood pressure medications, my blood pressure reading caused the alarm to go off on the machine. I heard the responding male nurse say "150," and he was concerned until it finally went down to 120 or 130 after a bag of water seemed to make the difference. I haven't heard from Nurse Mark yet.
    I have been thinking about this situation, and this is my suggestion to PA Paul: Don't leave me on only a blood pressure pill, Benazapril, that doesn't work by itself anymore. Prescribe something temporarily while I'm off Amiodipine Besylate to supplement the Benazapril.
    I plan to make copies of this and drop one off for Jody Dodge, the administrator at Brattleboro Memorial Hospital and one for PA Paul at the front desk at Brattleboro Internal Medicine.
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary
    MS at VCU, 1975 and MSW at NSU, 1993

Bowel Obstruction #6

Wednesday, April 20, 2016 3:45 pm:    After taking the laxative and purging my bowels, I find I am still in the same position of passing poop pellets instead of bowel movements. I decide that maybe that laxative wasn't enough and take a second one last Monday, two days ago. I go through the same disgusting purging and again on the day after find I still am constipated and still passing pellets. I am drinking prune juice several times a day, beet juice, and another juice with about five fruits in it. I am having a salad a day and vegetables and fruits. There's a small improvement: I am passing today some chunks of poop but have gas so loud that it sounds like cannon fire and the chunk hits the toilet water so hard it smacks water onto my butt!
    I call the Walmart pharmacy and ask if the second blood pressure medication- Amiodipine Besylate- that PA Paul Stanchfield prescribed for me could be causing the trouble. She asked if it could be the Paxil, but I didn't think the timing was right. She said that AB could cause diarrhea, but on the other hand, it could cause dry mouth. I said I was having the latter lately. She replied that it could be the blood pressure medication then and advised me to call my doctor. There's the rub, but I'm hoping things have changed now that Jody Dodge has stepped into the silence. I call Nurse Mark per protocol and have to leave a message. I explain that Dr. McFadden in the ER had asked about a new drug causing constipation and Walmart had said it could be. I asked that PA Paul try another BP drug and asked Nurse Mark to call me. I made that call at 12:58 pm. If anyone can shed some information on this situation please contact me at 352-359-0850 or peternickerson12@yahoo.com.
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary
MS at VCU, 1975 and MSW at NSU, 1993

Bowel Obstruction #5

Tuesday, April 19, 2001  7:15 pm
    Upon getting home from the hospital and the Price (and hours) Chopper, I take the laxative and decide to devote the next day to the consequences of that act. I turn off my cell phone. When the next day ends, I don't feel so bloated. Thursday, I turn my phone back on and start answering calls in order. Paul Stanchfield, PA, leaves a message saying he called last week and left a message saying my X-rays were normal. I don't believe him because I picked up the X-ray orders from him at the receptionists' desk Thursday afternoon, took them right over to the hospital, had my X-rays, and was told by Brandy, the tech, that it would take 48 hours for Paul to get them. Unless the X-rays were received at Physician's Group on Saturday (it is not open on Saturdays) and Paul were there, there's no way he could have gotten the X-rays last week. Plus, his supposed response was suspect: the X-rays were normal. Bye. That's it? Was I expected to tell that to me lack of a bowel movement but only pellets and the bloated stomach and the slight stomach ache, and they were all supposed to shape up? What was the next step, Paul?
    Paul also said I should go through Mark, and it was all right if I didn't want to, but I should anyway. Well, that's very accomodating. I should be content with being rude to by Mark? Paul said that if messages went through receptionists, they tended to get lost. Not in my experience. The receptionists are very dependable.
    Then I listen to a message by Rena who says she transmitted my prescription to Walmart on Tuesday night and had a written confirmation of a successful transmission. I don't see how that's possible unless Walmart was wrong.
    I call Jodi Dodge, administrator, back. She throws me a very small bone by agreeing it was rude of Paul not to introduce the young woman with the machine. I would have said nothing about it if Mark hadn't been so rude to me. As I've said, he refused to answer a direct question -next time, I won't let him get away with it- and then after he pored silently over his laptop a minute or so, he got up and left without saying a word to me. I read the WSJ daily and listen to John Bachelor at night. I am very worried about the Islamic Caliphate that Obama has allowed to happen by his "lead from behind" approach. We're behind alright! Was it the last caliphate that almost conquered Europe, only being stopped in France? When Nurse Mark abruptly and silently left, I wondered if he had read a "bomb in the building!" alert and wasn't just leaving me behind. I listened to hear if other staff were leaving the ship too, just forgetting about the patients so they wouldn't have to compete with them on the stairs and in the elevator. I didn't hear anybody sneaking away out in the hall though. So I was very much on edge when PA Paul and the very young lady with the machine in her hands came in.
    I  tell Jodi that I wanted to try to work with Mark and Paul. I had always found Mark a little prissy, but knew I had my own inimitable style too. I liked Paul's seriousness even if he did push my Chronic Kidney Disease Stage 11 harder than Dr. Rinder did. I tell her I hope we can all work together again.  I tell Jodi I didn't expect we would have the same problems again. When I get home, I get a call from Rena who identifies herself as Paul's scribe. I'm tired of being so assertive and don't ask what "scribe" means in her context.  She says she's heard that there was a problem with my insurance and the Paxil. I say there's no problem, that when I got the Paxil, I just took it and ran. She sounded very nice, and I didn't think we'd have any more problems.
     Peter Nickerson, Philosophy Major, Class of '68, William and Mary
     MS at VCU, 1975 and MSW at NSU, 1993

Bowel Obstruction #4

    !:45 pm Friday, April 15, 2016:
    The receptionist for the emergency room asked me maybe two simple questions and said to go on into the ER. All day, I had been practicing deep breathing to try to calm myself down. I walked in, was shown into my room by a male nurse, walked into it with him, and a medical doctor was right behind us.
I was taken aback by her very young age, her smallness, and the slimness. I wondered if I was getting a teenage genius doctor. I was my usual direct, open, concrete self with her. Her name was Dr. McFadden. Patricia, I think. Within a few sentences back and forth, I was comfortable with her. I was internally seeing
her as a modern woman but with the spirit and toughness of the Irish. After a week of not feeling safe, I now did. She assured me that she could look at the X-rays Paul Stanchfield had but wanted to order a CAT scan to thoroughly see my lower abdominal area to look for obstructions. The nurse had me lie on the bed, and gave me a remote for the television. The latter is a great treat for me as I can't afford televison. Philosophers don't make much money. I turn on the TV and start watching the History Channel's series on people trying to survive in the wilds of Alaska. This particularly interests me as my father and mother were in Alaska in the 40s preparing to homestead in the boonies when mother got pregnant with me and insisted we return to the USA. The needle poker comes in and makes a hole for the IV. The nurse sets up the IV and then starts setting me up with a machine to take my blood pressure. Immediately, an alarm goes off. "Your blood pressure is too high," the nurse say. Holding my wrist, he adds, "So is your pulse rate." He fiddles around me and then says, "They're still too high. I'm going for something." He comes back quickly with a bag of water and puts that into my IV. "Let's see if that helps. Give it a little time. I'll be back." I wonder if I'm going to stroke out and try to change the subject mentally by watching how I would have lived if we had stayed in Alaska. It looks cold, lonely, hard, but extremely beautiful. Having sled dogs would have been fantastic. The nurse comes in, takes my vitals, and finds they are acceptable. I  wait for my CAT scan while I watch brutal life in Alaska. The nurse checks on me, seemingly surprised that I'm watching such a program. Do I look that much like a sissy? Soon my bed and I are wheeled over to the CAT scan room. It takes only a few minutes and I'm wheeled back into my room. The "teenage" doctor comes in and tells me it will take about 10 minutes for the Dartmouth hospital in New Hampshire to read and interpret the scan. I ask about Paul's X-rays, and she says she's having a little problem with that and will try again. Immediately, she's back with a piece of paper apologizing, "All I had to do was push another button." I look at the paper and think, "That's all Paul had to do, and he wouldn't?' By now I am very respectfully calling Paula "Doctor." I'm impressed with her, the rest of the staff, and the machines. The paper says there's nothing wrong except that there's a rough area in my ureter. I even think I hear the words, "a bend." I say I'll tell my urologist about it. Two different people talk to me about getting a primary practitioner, one giving me a phamplet of how the hospital will do it for me. I find "needing a primary practitioner" ironic. The doctor comes in to discharge me, asking me for questions first, and then suggests I take Milk Of Magnesia for constipation. I agree, thank her, and she leaves. Then a worker takes out my IV and tells me I can go. Greatly relieved, I walk to my truck and call Wendy, my daughter in Florida -the veterinarian-to-be. No answer so I leave a message. Then I drive to Price Chopper to get the laxative. The store is now no longer open 24 hours but is closing at midnight - in ten minutes. A worker marches me around the store to find the laxative and go to checkout. I see that there are no checkout clerks anymore. They've been replaced by about four self-service checkouts. I see this and mentally ask, "And they want workers to get $15 an hour? There won't be any more workers. But the crazy socialists can't see that. They think they can legislate anything, and it will just magically happen because they passed a law!"
Peter Nickerson, Philosophy Major, Class of '68, William and Mary,
MS at VCU, 1975 and MSW at NSU, 1993