Monday, April 25, 2016

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
   

Thursday, April 21, 2016

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

Wednesday, April 20, 2016

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

Tuesday, April 19, 2016

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

Friday, April 15, 2016

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
    

Thursday, April 14, 2016

Bowel Obstruction? #3

11:53 am Thursday, 4/14/16
    I typed Tuesday's events in the afternoon into this blog after talking to Kate who told me she was so sorry this was happening to me. I took a copy of it the posting plus Bowel Obstruction #1 to Brattleboro Memorial Hospital to give Kate.She had gone home, but the receptionist - you see how constantly I have to work with receptionists- put the two posts into an envelope to give to Kate Somebody.
    It was five o'clock and the Physicians' Group closes then, I believe, so I called Walmart to see if their prescriptions employee had sent my Paxil prescription over. She hadn't. I considered going to the police station to make a complaint against her for withholding medical care to a senior, but talked on with the Walmart worker. She's says they will prepare some Paxil for me. I am greatly relieved. I told her I had to rely on Paxil last night that had been out in the cap of my truck for two years so I didn't know how good it was. She remarked, "Oooo!"
I was greatly relieved to know I had my Paxil.
    I checked my voice mail and listen to a message from Kate Somebody who is the other hospital administrator besides the CEO. She tells me about all the people she has talked to concerning Paul Stanchfield who refuses to return my calls so I can know what the X-rays for my stomach obstruction say and who also doesn't call to tell me why he's not returning my calls even after my ex calls from Florida to ask him to contact me about my X-rays and to get my prescription over to Walmart. Of course, she isn't able to talk to him, only a receptionist. Is anyone available besides the receptionists?
Kate also says she has talked to a Ms. Peterson, supervisor of the practitioners at the Physicians' Group, and Ms. Peterson will be callling me.
     I call Kate back. She's not there, of course (but I bet the receptionists are!) so I leave a voice mail telling her of the prescription clerk employee not sending into my pharmacy just like yesterday. Now that employee has exceeded the 48 hour cushion in which to send in prescriptions. I tell her I have considered making a police complaint of abuse by withholding medical care to a senior with a disability for both Paul Stanchfield, a physician's assistant employee, and the prescriptions clerk, also an employee. I tell Kate that this situation is so stupid and malevolent that it scares me. We hang up. Unfortunately, I get flustered and anxious very quickly. Maybe it comes from having a father who started threatening me with death at age 2 and continued that threat and the threat of reform school until I went to college at 17. Unfortunately, they didn't have child protective services in those days. Isn't it telling that I went on to become a child protective services worker? Despite my high anxiety about what Paul Stanchfield and the prescription worker are doing to me by deliberately neglecting me, I'm  standing up to their abuse whatever the consequences.
    I go home, and since I have felt like I need to go to the bathroom constantly for the last month, I go to the john. I strain and push out a couple of pellets of poop and look down at them. There is pinkish blood around one pellet. That's enough! I get back into the truck and drive to the emergency room at Brattleboro Hospital. In the parking lot, I first call my daughter, Wendy, in Florida,who is studying to become a veterinarian. I tell her where I'm going, just in case I have to have an operation. I promise to call her back if it's not midnight. I enter the emergency room and go up to the receptionist. Thank God for the receptionists!
    Peter Nickerson, Philosophy Major, Class of '68, William and Mary, MS at VCU, 1975 and MSW at NSU, 1993.

Tuesday, April 12, 2016

Bowel Obstruction? #2

    I called Walmart until about closing time last night. The worker did not send in my order for Paxil even though she said herself that she knew I only had one and would expedite things. I made copies of the last posting and went to Brattleboro Memorial Hospital Emergency Room. The receptionist was busy on the phone so I just put the copy on the desk, saying to her, "If I come in unconscious tonight, you'll know what's wrong."  I went out to the truck and found an overnight bag that I had used with a girlfriend two years ago. I found some Paxil, but I have no idea how old and potent they were. They put me to sleep until 2:30 and then I was awake until 5 at which time I took ZZZ-Quil and got back to sleep.
    I waited until noon the next day for PA Paul Stanchfield to call me back and started making calls myself. I tried to call the prescription worker at 802-257-26111 to find out what happened with my no Paxil last night at Walmart. I had to leave a message. It's 3:05 now and she hasn't called back. I also called the hospital at 802-257-0341 and asked to talk to the president or CEO. I was shunted to "Kelsi Gatley" who was not there. I left a message asking to call me. No response yet. I then called back to see if there wasn't some administrator on duty. I got shunted to "Jody Dodge" who was not answering and had to leave a message. I called Josyln Smith, the receptionist back who advised me to wait two hours and if I didn't hear from them, call her and she would hunt around for me.
    I waited the two hours and called Josyln, who was still friendly and engaged with me. She called around but could find neither. "Do you mean you have no administrators on call?" I asked. This is not an exact recording of what was said.
     "Well, they're at meetings and things."
    "And I'm supposed to be ignored?"
    Well, no, but they have things to do."
    "Do you realize the millions of dollars and hours of time it would take if I died and a suit was brought against you - the hospital."
    "Just a minute, I'm going to have you talk to my supervisor."
    "Thank you very much."
    I waited and a lady said, "Kate."
    Pen in hand, I asked, "Who is this?"
    "Kate."
     "And you are?"
    "Patient's Access Supervisor."
    "You are exactly what I need! Kate I am really worried about this going too far and it will be such an egregious mistake that Paul Stanchfield and the hospital will deny it and try to turn it back on me by villifying or demeaning me."
    "Well, what is your problem, Mr. Nickerson,"
    I explain including the bowel obstruction, as I suspect it is, and the blood in the toilet last Sunday, and having only one Paxil left yesterday and the worker not callilng over to Walmart even though she knew that. Kate wanted to know what worker told me Monday morning that Paul had the X-rays, but there was no way I was going to remember that. She was already head-hunting but for someone way down on the
totem pole whom it's no problem to discipline. Kate disarmed me by sounding warm and genuine and repeating "I'm so sorry this happened to you." She promised she would look into the problem right away. I told her I didn't like being in an adversarial relationship with my PA, his staff, and the hospital with whom I had enjoyed a lot of warmth and brief comments. I asked her too to think of the possible conseqences if I were to die. I told her I was walking around feeling like I needed to go to the bathroom all the time plus my stomach ached a little. I told her something had gone wrong, and I felt they didn't like me anymore. That there was now something about me that they didn't like. I told her all that I wanted was Paul to call me about my X-rays and the woman worker to call Walmart and authorize my Paxil. I said, "It's all so easy. So quickly done." She promised to look into it and call me.
    I had called my daughter earlier to call Paul on my behalf. She didn't pick up but I left a message to Wendy that I needed help. I heard from her mother that Wendy was getting her nails done, so my number, and immediatley called her mother, Lee, to see if she was allright. I've called Wendy before when I can't reach her mother. I worry about my ex running 10 miles or so every day out in the boonies without a gun. She's had some bad experiences. I then called Lee asking her to call Paul and say that I'm waiting for his call and my medicine. She talked to Denise whom she didn't find particularly warm. She also heard a male with a high-pitched voice kibbitzing Denise. I told her that must have been nurse Mark. I also wanted to impress upon the staff that I wasn't just a poor piece of shit but I had an intelligent, assertive family as well. I told that to Lee. Lee said that Denise had perked up in interest when she said I had clinical depression. I was not happy to hear that because it is my fear that these people are going to deny me medical services because they don't like me anymore for some reason. They also aren't going to admit their negligence but try to put the whole thing on me. Taking  a macro view of these events, I am seeing that structurally the hospital is more designed in some areas to protect the staff rather than provide
services. Look at all the positions, and no one for me to call for hours.
    Earlier, I had called my daughter to ask her to call Paul Stanchfield. I worry about. I apologize for the typing. Running out of time and left my glasses in the truck.
    Peter Nickerson, Philosophy Major, Class of "68, William and Mary