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        The goal of Obamacare is to make high quality health insurance available to all. It's basically a mandated means to finance that industry, government welfare, if you will, large percentage of Medicaid signups at this juncture notwithstanding. But what about the value to patients in the underlying medical treatment they are now paying to procure access to? Won't it be stretched thin with all the newly enrolled that are being dumped into the system? Does anyone care?!     Below is a rendition of encounters I had with various providers over a one year period, in the shadow of the Capitol, in the President's backyard...to be continued. It begs the question that the drafters of the Affordable Care Act dared not ask - but that implementation of that law will eventually answer: Does having quality health insurance equate with receiving commensurate value in medical treatment? I would have to say NO.                                                          DIARY OF A MAD MICROBE   I. June 3, 2011. My left pelvis is left paralyzed after routine physical therapy. It starts within hours of treatment, on a Friday night. So much for the weekend. The following Monday, I return to the practitioner, who I had been seeing biweekly for 15 years. Her cold comment: something must be really wrong for me to return for an unscheduled visit. I leave in no better shape. No one in her facility was able to help, but...
II. My longtime - yup, 15 years - acupuncturist could. The bad news: it took a few more days to get in to see her. The good news:  on June 9, 2011; she got things "moving," if you get my drift. Including an infection that had blossomed in the interim and been trapped. Finally, help at last...
III. Not so quick. Almost, immediately I notice swelling under my right eye, and vaginal discharge, which I hadn't seen in - umm - eight years, since becoming menopausal. Enough disclosure on that. Head on the desk exhaustion sets in. Walk in Doctor I prescribes Z-pak, which works like a charm on the sinuses, but does nothing for my seeping sex organ. I am now bloated, full of gas, and it appears I have a UTI. Another reason to dislike June besides its association with my ex-husband (20 years).
IV. Onward, into July. Next stop, Doctor II, the gyn, who proceeds to tell me what I am suddenly seeing is from an allergy to detergent - yup, that Arm and Hammer Free for Sensitive Skin and Ivory Soap will get you every time - and that the belly issues are a result of my digestion being too fast and incomplete. She sends me packing after taking a Pap Smear - and nothing else.
V. Later that same month, I see Doctor III, a primary, and finally some blood and urine are drawn. Yep, there's an infection SOMEWHERE. Cipro for me despite a long list of lesser drugs I can't take. I land in the ER via ambulance, dizzy, where more tests are done that show in addition my sodium and chloride are very low. No electrolytes are administered. Red herring or another clue? It's August, and I am fast losing any remaining awe I may have had of the medical profession.
VI. Meanwhile, back at the P/T,  light dawns on dunderhead and I realize that part of the pain in my neck is coming from unnecessary traction that  has  recently been set at the wrong angle and at too high a weight. I protest; the response: "You can take it." I stop it, only to be subsequently subjected to equally superfluous heat and stim, which I quickly discontinue as well. Business down; modalities billed up. Hear that BCBS Federal!  It's my body. APPARENTLY NOT. Longtime loyalties die hard, but I'm getting there.
VII. September  - ah, Fall, my favorite season. Not this year. I notice the globulin on the bloodwork from Doctor III is low, and shouldn't be since I have been taking quarterly injections of "gamma" for my fibromyalgia at my rheumatologist's office for, you guessed it, 15 years. I call an immunologist/infectious disease specialist, Doctor IV. I'm a new patient; he can't see me until mid October. So I wait. Which at this point is about the same as going to another practitioner. I start to feel like I am dying and won't make it to my next birthday which is...
VIII. October 13th. I won't say which one. Not a Friday. After glancing at my records, Doctor IV tells me he doesn't know why I am there. No joke. I force him to take my Immunoglobulin G levels. The results come in one morning early the following week and I am called into his office that afternoon. Subclass 3 - antibodies - 5. The range starts at 22. When he walks in, I quip "now you know why I am here." Patient knows best. Scary.
IX. I am immediately started on monthly Gammagard infusions. I feel better for six weeks, and then crash.  All treatment is stopped as I am evaluated by Doctor V, the rheumotologist, who has decided he wants to be "in charge." I get MUCH, MUCH worse. My physical therapist yanks my SCMs, those large V shaped neck muscles, and my iliopsoas, which are the deep hip flexors, and sends them into spasm. So much for my long stabile fibromyalgia, which is why I see her in the first place. I can't eat, breathe or sleep - or sit or walk for long periods of time. A not so Merry Christmas. Breaking up becomes not so hard to do.
X.  The New Year, and I decline even further. Naturally skinny, my weight drops dangerously low. Doctor V runs some additional tests which reveal systemic inflammation. I think the infection I have been loudly complaining about all along, and whose existence is clear from prior results, collapsed my immune system, and along with the antibiotics retrigged an autoimmune response and tell him so. (Thank you, Mom and Dad, for that pre med Muhlenberg education) He refuses to make a definitive diagnosis, but charges me for several lengthy office visits and to read my records, basically identical sets, twice. I am not up for anymore "making money off my body" and  take control and "charge" out the door, albeit gimpy. Give me liberty...or give me death...
XI. I end up in the ER in March in excruciating pain. First trip, I get a pediatrician, Doctor VI,  who asks ME what I want to ease it. Atavan, some morphine like substance that began with a D, or Flexeril. I pick "A." She notices the lymph nodes on the left side of my pelvis are protruding - standing at attention, actually, but apparently not enough to get any from her - screaming infection. I am knocked out with Ativan and when I wake up two hours later, my exit papers are literally being thrust in my face. Been there too long; got to skip that underlying cause. Time is their money. A week later, I'm back again to the same emergency facility, writhing even worse. This time Doctor VII treats me like a drug seeker and I am sent on my way even before my blood and urine tests come back. Ironically, I'm probably one of the few baby boomers who never indulged. Through all of this, I attempt to do the taxes.  My portion of the medical bills for 2011 - $12,000. A nice sized itemized deduction, but not much else to show for it!
XII. I return to the primary, but this time I am scheduled with a newbie colleague of Doctor III, Doctor VIII. She keeps her nose in her laptop, refuses to review the stack of paper records I have brought to the appointment, tells me when I approach her on it that I make her "nervous" and to go back to the table, where she fails to ever come to examine my pelvis although that is the purpose of the visit and I am visibly suffering. Although I tell her I cannot take any meds that interfere with urination - why I didn't choose Flexeril in the ER - she prescribes Xanax, which I find out after leaving the pharmacy does exactly that. The RX goes unused and still sits on a shelf. Medication can't be returned.
XIII. Fed up, I go back to Doctor II, the gyn, and demand she test my vagina for bacteria. She protests, saying she won't find anything, "menopausal women get discharge, they just don't want to hear it." The culture results : ABUNDANT staphylococcus aureus. I'm right. Apparently to deflect potential malpractice, she then insults me, in an open and occupied area, by trying to tell me I gave it to myself. Yeah, right, I paralyzed my pelvis on purpose! I told her what happened almost a year ago!  She writes a prescription for Suprex. The infection is apparently more superlative than the drug since the subsequent testing comes back the same - still ABUNDANT. It's MRSA! She sends me packing, again, to...
XIV. Doctor IV. He gives me Zyvox - twenty pills for ten days at $100 each. No generic. You do the math. My hands and feet start to tingle half way through, one of the very long list of serious side effects, and am told to stop for a few days, and then resume at half the dosage. Seems like I am on it forever. It is constipating! My "belly bump" is already way off center due from all the internal and external trauma my pelvis has been subjected to. I don't need to add passing rocks. But it does the trick. It is June 2012. One year has gone by. My Subclass 3 is 7. There are at least five more infusions in my future. But at least I have one...despite "care" that was for the most part wasteful and bad for my health. Not only the microbe is mad.