Our Journey through Healthcare in America, Las Vegas Style
Saturday, September 22, 2007 at 12:39AM

It's funny, the things that trigger your memory. I'm standing in an elevator at the Las Vegas Springs Preserve. I have an event in about an hour on Growing Up in Early Las Vegas. I am hoping people attend and am hoping the heat does not keep them away. It is my first event at the Springs and I would like for it to be successful.

The young man who is escorting me to the Library building pushes the button for the lower level. The sound the elevator button makes is the first three notes that a ventilator alarm makes.

Suddenly, I am no longer in an elevator at the Springs Preserve but back at Valley Hospital remembering the most harrowing month I have ever had.

A little back history.

Way, way back. (Please step into Mr. Peabody's machine). When I was a little, little girl back in 1959, my mother and my Bio-dad had a rocky marriage. My mother met a wonderful man who was not my Bio-dad. She and Bio-dad divorced. My mom and Mr. Wonderful began a relationship. It, too, got a bit rocky in 1961. We all ended up in Las Vegas in September, 1961.  Mr. Wonderful ended up following my mother out to Las Vegas a year later.  Long story short, my mom and Mr. Wonderful were married in 1963 (and have been happily married since then).  In 1964, my mom was pregnant and there was concern that I would feel left out having a different last name than the rest of my family.

I was adopted by a man who had not contributed to my birth but who would raise me as if I was his very own, no questions asked. It was not always a harmonious relationship but the 1960s and early 1970s were not a harminous time. He taught me to question, instilled in me the desire to know more and always pushed me to strive to be the best I could be. He is, in short, my dad.

As he grew older he was plagued with health problems including a stroke that ultimately left him paralyzed and in a wheelchair.

Not so far back: (Please step out of Mr. Peabody's machine) 

In May of this year, through the care of a wonderful cardiologist, we learned that his heart arteries were blocked. Stents were put in and my dad began to feel better. The cardiologist, Dr. Rah, thought my dad's cartoid arteries were likely blocked as well and thought that blockage may have contributed to his stroke back in 1995. He referred my dad to Dr. Holland, another cardiologist who specializes in carotid ateries. He wanted to my dad to see Dr. Holland, a cardio-vascular surgeon, as soon as possible as he believed that my dad could have a stroke at any time due to the severity of the clogged carotiod arteries.

He wanted my dad to have some CT Scans of his carotiod arteries done before making the appointment to see Dr. Holland. My parents have Senior Dimensions Healthcare. Trying to schedule the CT Scan appointments became a Catch-22.

We would call and try to make an appointment for my dad to come in. The schedulers would tell us they could not make the appointment because the referring doctor's office had to make the appointment. Dr. Rah's office would tell us that it was not their responsibility to make the appointment.

At this point I began to wonder how other people deal with the frustrating healthcare policies that seem determined to keep you from getting the care you need. If I had not been there to call every day and try to break through the Catch-22 (and there were a few days where we spent hours on the phone), what would have happened to my dad? He likely would have given up trying to make the appointments due to aggravation involved in just trying to get someone to do their job.

After going around in circles for over a week, we finally found a savior. Lynn, a nurse in Dr. Rah's office, listened as I explained the frustrating situation that the Catch-22 had us in. She understood completely and said she would see what she could do. Within 24 hours she had the CT Scans scheduled and the follow-up appointment with Dr. Holland.

The CT Scans, of course confirmed what Dr. Rah had suspected. My dad's carotiod arteries were 95% blocked with plaque. We met with Dr. Holland who agreed with Dr. Rah and a date was set for surgery, July 16th. Dr. Holland would do the left carotiod artery first and then a few days later do the right carotiod artery. We finally felt like we were making some progress.

On Monday, July 9th, my dad complained of chest pains and of not feeling good. Later in the afternoon he got that ashen look about his face. He refused to call the doctor or let us call the ambulance. He can be stubborn and hard-headed. By early evening, the color had returned to his face and he was feeling better. A little after midnight, he woke us up saying he has having severe chest pains and wanted to go to the hospital. We called 911 and they sent an ambulance.

They took my dad to Valley Hospital's Emergency Room (it was the one hospital in the Las Vegas Valley where both Dr. Rah and Dr. Holland had privileges). The EMTs were great. The Emergency Room staff was terrific. About 3:00 am, as my dad was resting comfortably and hooked up to a bevy of monitors, I took my mom home.

The next morning I talked with Dr. Rah who ordered up some tests. My dad was in a room on the fourth floor.  The tests showed that one of my dad's heart stents had collapsed and would need to be repaired. It wasn't a complicated surgery and everything went off without a hitch.  After surgery, he was sent to a different room on the third floor for step-down ICU patients. Dad did great after surgery and on Thursday, July 12th, the case worker was making arrangements for dad to come home for the weekend before coming back to Valley on Monday for carotiod surgery.

Friday, July 13th, an apropo day.  Because my dad is paralyzed we can't just take him home.  He has to have Medi-Car transport him home on a gurney.  The case manager comes to his room around noon to tell us that Medi-Car would be there about 3:00 to take my dad home.  The nurse got my dad dressed and ready to go.  We signed all the paper work releasing dad from the hospital.  Well, 3:00 came and went as we watched sitcom after sitcom rerun on TBS (the hospital which is only a mile or so from Cox Cable only gets maybe 10 stations, including the  5 network stations).   We asked the nurse what had happened.  She made some inquiries and discovered that Medi-Car had been there but they had gone to my dad's old room on the 4th floor.  When they didn't find him there they left.  I shook my head in disbelieve that the Case Worker, who had to come into my dad's room on the 3rd Floor to talk to us, could give them the wrong information.

It was Friday afternoon and the daylight was ticking away.  I didn't want my dad having to hang around the hospital until 9:00 at night waiting to go home because he would only have a short time at home to begin with.  Medi-Car, to their credit, was able to come and get my dad and he was home by 6:30 pm.

The First Five Things I Learned about Healthcare in America, Las Vegas Style:

1.  Be the squeaky wheel.  The old adage is right.  The squeaky wheel gets the attention.  Your loved one's health is at stake here.  Forget the idea that you care about what people on the other end of the phone think of you.  Your primary goal is to get the needed care for your loved one, not to be liked by people you will likely never meet.

2. Don't lose your temper.  My friend Al, in Phoenix, who used to work for America West as a boarding agent, reminded me early of what he would say to passengers who lost their temper.  "You're yelling at me and you want my help?".  No matter how angry you get, try not to lose your temper.  You'd be surprised how far you can go on a slow burn without ever raising your voice and how effective that can be. 

3.  Don't be afraid to ask for a supervisor.  Tired of the Catch-22, tired of not making any progress, go up the food chain of command until you find someone who will actually listen to you.

4.  Healthcare doesn't make it easy and it shouldn't be this difficult.   The reality is that, in this day and age, the more obstacles they throw up feels like they hope to wear you down.  If they wear you down,  you will go away and it will cost them less. 

5.  Your loved one's health and life is at stake.  Never forget that.  Doesn't mean you have to turn into a raving maniac but  you should realize that you are going to have to br alot stronger and much more vocal than you ever realized.


Up next:  Carotiod Artery Surgery and what can go wrong, will go wrong. 

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