Keep the government out of healthcare! (Except in Texas)

I’ve always said that Texas was like it’s own country. Actually, it was it’s own country for about ten years back in the 1830s, but this isn’t a history blog. Anyway, a law in Texas went into effect to force women who want to have an abortion to be submitted to a sonogram. Furthermore, the physician performing the sonogram and/or abortion is compelled to explain to the woman all that is being seen in the sonogram. See, on the one hand, Texans want the government out of the patient-provider relationship. On the other, they want the government deep inside the patient-provider relationship. Deeper, I’d care to guess, than the fetus itself.

Don’t take my word for it. Read the law yourself.

Supporters of the law will tell you that they just want the woman to be well informed about the procedure she is about to undergo. By saying that, they are implying that providers who provide abortion services are mischievous and don’t tell women everything that goes into having an abortion. Somehow, the medical board is not good enough to catch these sneaky providers. Current laws in Texas are not enough. No, to serve those poor women who are apparently being tricked into abortions, the law was passed.

Opponents of the law will tell you that the law imposes itself on providers, telling them how to perform a medical procedure. They will also tell you that the law does not exclude victims of rape and incest, making them go through yet another medical procedure (the sonogram) in their ordeal.

What gives, though? Rick Perry, who signed the Texas bill into law, decried “Obamacare” as the government interfering in healthcare. But that is exactly what the law is doing in Texas. I guess it’s a “state’s rights” thing or something, like how Mitt Romney detests “Obamacare” but a very similar law was good enough for Massachusetts when he was the governor there.

So we’ll see what happens now that the 5th Circuit Court of Appeals has said that the law in Texas can be enforced while it winds itself through the legal system. It appears to be headed to the Supreme Court, and we’ll have a “Roe v. Wade” type mess on our hands all over again.

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You’re supposed to feel pain

You hear it time and time again. The patient goes in to see their provider, complaining of some ailment – or ailments – that is causing pain. The provider prescribes some sort of pain killer in order, well, kill the pain. The patient then tells the doctor that the pain killer is no good, that they’re allergic to it or something like that, and that they need something “stronger”. The provider just goes ahead and gives the patient what they ask, maybe because they don’t want to deal with the issues of a potential drug seeker.

I don’t know exactly when it happened, but pain was declared a “vital sign” at some point recently. Upon being triaged, patients are now being asked to rate their pain on a scale of some sort. In my experience, the scale is 1 to 10. One is for a dull feeling, like when you get poked. Ten is the worst pain imaginable – think of having your limbs torn from your body as someone pours hot lead onto the stumps. (I think.)

Of course, people with a strained back that just won’t heal began to report their back pain as a 10, though it was clearly not that bad. Like any other vital sign, pain had to be reduced or brought under control. After all, you don’t let someone with an incredibly high blood glucose level or blood pressure walk out of your emergency department, do you? But the problem was that these folks with simple injuries being reported as a 10 had developed a tolerance to pain. So newer and stronger drugs were developed.

The problem with those newer and stronger drugs is that the human body is a wonderful piece of machinery. This wonderful machine can adapt to almost anything, pain being one of those things. The more a pain killer was administered, the more the pain receptors in the body adapted. The pain receptors became more sensitized, “scanning” more deeply for any signs of injury. Pain, after all, is how our body notifies all pertinent body systems that something has been injured and needs to be repaired.

So the person gets better and stronger pain killers and the pain receptors are still picking up pain. That, and the injury that caused the pain is not properly addressed because, hey, it just hurts too much to go to physical therapy or to have a surgery. The surgery itself may even bring about more pain. They are cutting into you, after all, and your pain receptors are cross-wired. And all this started at the beginning, when the pain from the initial injury was quickly and swiftly treated with a pill or two.

Now, many of you who are lurking this blog have claimed that I’m a shill for the pharmaceutical industry. If I am, then why am I right now stating that the medical field would be much better off if drugs for pain didn’t exist? There’s a lot of money to be lost if alternatives for drug medications were developed. Yet, no, I’m not talking about acupuncture.

I’m talking about telling someone who comes in with a busted hand from punching a wall that, yes, it’s going to hurt. It will probably hurt for a while as it heals. Tell the person in the car accident that they will be sore for a bit being as how they have just been in a car accident. Explain to the 450-lb man that his knee is not going to get better on pain medication alone until he loses, say, 5 stone.

Yes, maybe techniques such as relaxing and realizing that pain is a part of the healing process could be used instead of right off the bat dropping the opiates. Maybe some aspirin? Maybe?

Then again, I’m not a health care provider, and maybe the standard of care has evolved to the point where pain medication is always indicated for any kind of pain regardless of the place on the VERY SUBJECTIVE scale where that pain may land. It’s a scary proposition, though. The body will continue to adapt, and this arms race of sorts will continue.

No arms race ends in peace.

You could work somewhere else, you know?

Some of you may not know this, but I used to work at a hospital in a previous life. Even though I wasn’t providing direct patient care – and mostly just did mop-up work, if you know what I mean – I was required by the hospital to be immunized against hepatitis B, measles, mumps, rubella, diphtheria, tetanus, and pertussis. Why? Because I could get hepatitis B from an accident with a contaminated item or surface, because I could contract measles and spread it around before I had any symptoms, because I could do the same with pertussis (whooping cough), and because, well, I’m not an asshole.

Seriously, I’m not.

Now, I know that Seth Mnookin was once criticized for saying that word in a conversation about vaccines. I’m not afraid, either. I’ll spell it out for you:
People who have no obvious reason to not be vaccinated and work in healthcare and refuse to be immunized are assholes.
You cannot possibly work around people who are sick to begin with and not do your part to prevent more infections. You just can’t!

These idiots in New Zealand don’t understand this. Even after healthcare workers have been infected with measles, they’re still spreading fear about the MMR vaccine, a vaccine which could save lives. What are they saying?

“It’s obviously important for St John Ambulance to take steps to minimise the risk to patients who could be particularly vulnerable to developing complications if they contract measles. It is a sensible precaution to quarantine staff who might have been exposed to measles so they cannot inadvertently pass the disease on to other staff or patients.” Smith says.
“However, I hope that St John will respect the human rights of its employees when planning a vaccination campaign and ensure that paramedics and other staff will be able make a free and informed choice about whether or not to be vaccinated.”

For crying out loud! Yes, they have a human right to not be strapped down and vaccinated against their will, but we’re not talking about that. We’re talking about people who want to work in healthcare having to do what they must to keep the people they’re working for safe. If they don’t want to take the vaccines, then they also have the God-given right to go work at some other goddam place.

Enough with the bullshit, already. Get the goddamn shot.

Yes, I feel better now.