A not-so-funny thing happened on my way home to California from Montana this week. I’ll probably never know what triggered it, but it was a life-threatening situation and a chance to experience the real world of medical care in rural America.
While some people are reviling the Patient Protection and Affordable Care Act (PPACA, aka “Obama Care”), the new healthcare law does offer some hope for real health care changes in rural America. Do we need it? Yes. Will it cost money? Yes. Is it worth it? Definitely… Yes! Let me tell you about my mis-adventure and you just may agree.
We had stopped for a lunch at a combination gas station/food mart/ fast food restaurant in a small rural town with a population of far less than 5000. I was feeling fine as I made a quick detour to the restroom. Then I noticed my eyes were itching. I took care of “business” then noticed my right hand was also itching, soon followed by the left. As I went to wash my hands I was overcome by a feeling of weakness, dizzy-ness, and itching all over.
I grabbed my purse and staggered out and to a nearby chair where I more or less collapsed. My husband, Ed, saw me and rushed to my side. We checked my blood sugar to see if it was low, as I am diabetic and take insulin. It was fine. But I quickly nodded, “yes,” when Ed asked if I wanted to go to the ER. Friendly folks in the food mart helped him get me to our car and told him how to get to the local hospital and ER,
First I would like to say that all of the people who came to my aid were caring and competent. The problem was their competencies were not really enough. There are over 15 doctors listed on the hospital staff, but this was Sunday afternoon, and no one was on duty in the ER. I was seen by a Nurse Practitioner and an RN. They were assisted by an X-Ray tech and some people from the lab.
However, without an MD on duty to check me out, I felt a lot like a patient in the TV show, “House.” At first, I was in and out of consciousness and Ed had to answer for me as they took my medical history. Basically, they treated me for shock while they tried to figure out what was wrong. They gave me a saline IV to raise my low blood pressure and warm blankets to raise my low body temperature. But, nothing for the itching. As I became more aware of my surroundings I noticed an unsettling poster on the ER wall advertising emergency evacuation flights.
My EKG was abnormal and my heart was skipping beats, but there was no chest pain at all… just a lot of itching. They did tests for heart attack and everything was negative. Strangely, it took a while for the rash to become visable, and when it finally did, they began to listen to my complaints about “itching all over.” They finally gave me some antihistamine via the IV. Relief at last!
Eventually, after about 5 hours, I had recovered enough and all tests for evidence of a heart attack were still negative, so they let us go on our way. At no time was I seen by a doctor. I will probably never know what caused this episode. We headed for a much larger town with several large hospitals (just in case) for the night.
Was this experience typical for emergency medical care in rural America? Sadly, the answer is yes. Medical costs are generally higher than in urban areas while, at the same time, earnings are less. Medical staffs are aging, as are their patients putting a heavier load on fewer practioners. It is difficult to recruit new health professionals to practice in rural areas even though the needs are becoming greater. The PPACA offers some help for the situation.
If you would like to see some of the provisions that can help, here is a report from an organization concerned with rural health.
Of course, as this report says, these helpful measures will all cost money. The PPACA suggests amounts that would have to be approved by congress each year to be implemented. The probability of this happening with our current congress is not good.
Chances are you live in an urban or suburban area where emergency medical care is widely available and of high quality. So, why should you care? Well, even if you never plan to travel to or through rural areas, you may have friends, relatives, and loved ones who will… or who live there.
In the case of health care issues, what affects rural America, really affects all of us. Meanwhile, my MD has prescribed an Epi-pen for me in case this happens again when we are traveling through, or staying in remote, rural areas… actually, like our Montana home.