Ask a nurse anything.

reply to post by Binder


Thanks for the info!

No anemia. And no substance abuse of any kind (two glasses of wine will knock me out for an entire evening!).

I'm Anything But a vegan (not that there's anything wrong with that!), I love me some roast beast, I devour salmon every chance I get (and those other fishies ain't safe either!). My A1c is consistantly below 7%.

And I have an egg substitute omelett almost every day for breakfast.

So I don't know what's going on, unless my old bod has just decided to go AWOL.


Still, I feel good, I'm verticle, I'm breathing, and I'm above ground, so I'm not complaining!

reply to post by Binder


Binder

Thanks you so much for your kind, thorough and thoughtful response. Dr Caresalot! LOL! I will endeavor to follow your advice. Reading your post has given me have new energy into getting proper health insurance and finding a good Doc.

Hello!

I am glad another nurse is here. I, also, am a male nurse with ICU etc background. I will preface all my statements with the following:

In the US, EVERYBODY has ACCESS to healthcare. Just as everybody has ACCESS to a car dealer. This doesn't mean everybody gets a Porsche.

In the US, 99% of the patients do NOT pay their own bill. You pay SOME of your bill, at best. Yes, you have insurance, I know. But remember, THEY are the ones paying most of your bill. So, the insurance company gets the bigger say in what happens to you. You want more influence in your healthcare, then pay more. It is very simple. Just ask anyone who has had to deal with Workers' Compensation. WC has thousands of number crunchers that study, track, and trend treatments and procedures. They follow very strict data trends on how to fix people.
For example, if you had to pay 100% for your neighbor's back injury, you would look for the cheapest way to pay, correct? Only a fool would jump right to the most expensive option right away (surgery). Another example, you don't go to the closest car dealer and buy the most expensive car on the lot, right? No, you shop around for what you need and what you can AFFORD. Insurance companies are the same way.

Nurses are mandated to give the SAME EXACT care to everybody, regardless of reimbursement. In other words, we are not allowed to change our level of care based on what the patient (or their insurance company) is going to pay. A lot of patients complain about poor healthcare and bad customer service. Many of these same patients complain about the cost of healthcare insurance. The rest of the industrialized world follows the same slogan: "You get what you pay for." Nursing does not. To make another auto analogy, everybody wants Ferrari quality care at Yugo/Kia (insert your country's cheapest car company here) pricing.

On a lighter note, please do not take offense if we don't not remember your name. As the other nurse here says, you are one of many people we take care of during our week. You will see just us during the day, as we will be seeing probably 100 people by the end of our shifts (MDs, PAs, RNs, Techs, janitors, secretaries, family, visitors, vendors, equipment reps, chaplains, priests, reporters, EMTs, medics, etc). That does not count any meetings or conferences we have to attend.

If any members have questions, I, too, will be happy to give my opinion of nursing issues.

Thanks for reading,
Nursejr

reply to post by Nursejr


Nobody asked any questions that your reply would apply to ... Mr. What's His Name ... we forgot your name already because you are only one of mere 100's of posters we read or reply to in a day.

Personally, I'll wait for Nurse Binder's answers to my questions to him, thank you anyway. Odd, I can remember HIS name. *smirk*

But to Mr. What's His Name ... you said (off topic)

Yes, you have insurance, I know. But remember, THEY are the ones paying most of your bill. So, the insurance company gets the bigger say in what happens to you.

Now THAT is totally unethical in my books. If we pay $418 a WEEK in insurance deduction AND have an $8,000 a year deductible ... and you imply that insurance pays the bill? Then who paid the insurance $418 a week eh? Santa Claus?

The patient should have the bigger say. That is quite clear. Even those without insurance. Insurance companies are the main #1 reason the medical crisis is where it is today. They take every penny the wage-earner clears after Uncle Sam, then, the patient has no money for proper nutrition or even for annual check-ups. Insurance companies are nothing but middlemen, skimming and extorting funds from both ends (Doctors and hospitals get burned by them too, so they double their prices to catch up and then insurance doubles their demands again. It's inflationary common sense.)

When I was a kid, there wasn't insurance. Parents paid cash; and doctor, prescription and even hospital prices were very reasonable. Families saved a special rainy day fund for family emergencies. Churches or neighborhood civic clubs or co-workers chipped in if there was an extraordinary medical need. Those were the days.

Let's see who Mr. Binder says should get the "bigger say" in what happens to us.

reply to post by Binder


Thanks for your reply. I'll mention Osgood Schlatter to my Dr. next time I go. I do use a foamy kneeboard most times when I kneel, and it does help. Maybe one of those braces might help. I wonder if these are causing my actual knee
pain, weakness, clicking, rubbing etc. I have a family history of RA, and besides my knees, my fingers, wrists, shoulders, and toes ache. Some days I feel like I'm 90 yrs old.

Thanks again for the reply. I'll ask my Dr. about it.

V.

reply to post by Binder


I've always wondered, being around sick people all day, how do you avoid getting sick? Does your immune system become stronger because of repeated exposure, do you take special measures to avoid becoming ill such as vitamins or are a majority of the diseases in the hospital not communicable? It seems doctors and nurses are sick less often than other people despite constant exposure to illness.

reply to post by Trexter Ziam


Ok Trexter, we're going to jump off into an ugly rabbit hole that most people don't like to look down. Not even nurses. NurseJr was partially answering your question, and I doubt that he was advocating that everything insurance companies do is right, good, and/or ethical. Nurses fight the system for you all the time. Alright, disambiguation here: GOOD nurses fight the system for you when, and where appropriate. Nurses come from a pool of human beings just like doctors, and cops, and clerks at the convenience store. There are great ones, and their are aweful ones.

Your question about policy on babies is founded a bit in some heresay. The birth of a child is highly emotional, and traumatic. The death of a child is earth shattering. There are times that a baby is born, basically without a brain(anencephalic) sometimes a child is born with other severe abnormalities that make the poor thing unviable, which is a fancy word for not a chance in hell it's gonna live. It would be in a lot of these cases unethical to feed this child because in a lot of instances it would make the child uncomfortable during it's short stay here with us, or part of the deformity makes it incapable of processing food. Enteral, and parenteral feeding is not as quick, and easy as it may seem. You don't just slip the kid a cheeseburger. Especially in the neonatal setting surgery is often required. Would you want to spend your only few hours, or days on earth under the knife, or recovering from it? That is not to say that things like you are suggesting do not, or have not happened, but it is rare, and a hospital would not maintain a policy, offcial, or otherwise of just not feeding babies that are high needs. There are regulatory agencies in place that would put people in jail for that.

All your questions fall under ethics concerns. Money, resources, education, etc... Health insurance is a risk pool. we all pay our $400-$500 a month, or whatever the premium is, plus deductables, and the rest of the money comes from the pool of money from the other million or so people in the pool that didn't ge sick, but payed their premium. $418 a month, and an $8000 yearly deduct is $13,016. That's about 1 day, and night's stay in an intensive care unit if you were really sick, and footing the whole bill out of pocket. Does the insurance industry play a role in the ridiculously high cost of healthcare in America? You bet it does. The whole dynamic though is extremely complex. It would probably surprise you that an average GP in an outpatient clinic makes about $90K to $110K a year. Yes it is decent money, but believe me if they are even a halfway decent doc they earn every penny. Specialists, and surgeons make a lot more. Big pharma also plays a huge role in the price wars.

Some doctors are guilty of "fluffing" the bill with test, and procedures. In some cases I can see why, and that they probably feel it is their only tool with which to fight the insurance company who is trying to pay as little as possible. In some cases it is driven by greed, and is just plain fraudulent. In some cases though it is a good doctor playing with the hand he, or she is dealt to give you the best care he, or she can.

All hospitals, doctors, and nurses should focus more on patient education. I'm also pointing the finger at myself here. It is easy to get caught up treating the body, and to forget to educate the mind, and keep the patient, and family up to date, informed, and asure a deeper understanding of what is going on. That's a big reason I started this thread.

The last statistic I heard was somewhere around 75%(not exact) of our healthcare dollars are spent in the first two, and the last two weeks of life. A lot of it on futile care. This is because as humans we are emotional creatures, not logical ones. That is a hard truth to deal with. Of course we want everything done to keep our loved ones alive, but sometimes there are fates worse than death, and they are usually administered by doctors, and nurses at the families request. That is why we have ethics commities, and I have been a member of many, and they get heated, they get ugly, and emotions always run high, but it is the best way to ensure that the best possible care is given to the patient. Sometimes what the patient needs, and wants is comfort measures, and most of the time saving someone hurts a lot. Sometimes quality of life trumps quantity. It is our job to help alleviate human suffering, not prolong life at all costs.

So it doesn't always have to do with the money, but sometimes it does. I have left ethics commities madder than hell, and ready to quit because I do not agree with the ruling. I have seen a patient basically starved to death when I thought it highly inappropriate, and Oh yes! I was VERY vocal about it!

Continued....

reply to post by Trexter Ziam


I have also seen doctors spend 12 hours or more at a child's bedside instead of at home with their family, even though nurses, and hospital staff were there to care for the child because the child had an irreversible condition, and was dying. Some docs take it very personally, and beat themselves up when they can't save everyone. There are good hospitals, and bad. There are good doctors, and bad. Although I hate to admit it there are also bad nurses.

The best thing you can do as a patient is advocate for yourself. Know what is going on, educate yourself, and when you have a question, or issue persue it until you get a satisfactory answer. Not that you will necessarily like it all the time, but try to always stay armed with the truth, good, bad, or ugly. End of life care, and decisions are always hard, complicated, and there is seldom a black, and white / right, or wrong answer.

reply to post by Nursejr


Hi Nursejr, thanks for joining in. Nice to see a familiar face. Looking forward to reading your input too. I work a mixed MICU/SICU/CCU right now, and for the last 8 years, but I dabbled in other stuff before that, and still do part time work in other areas. I'll try to keep my responses tame for the uninitiated so as not to cause an inadvertant code brown!

Thank you for your replies.

It wasn't heresay really, a pediatric ward nurse told me they do it all the time - but - that was 60's and 70's.

So, they intubate the encephilitic sp. or (anencephalic) babies now? Or, it's not required because they only have a medula oblongata (vital organ regulator - might have the wrong name there - the brain part closest to the upper spine) - and are considered brain dead? Do they still tell the parents it was born dead, even though it wasn't?

I'm glad they put regulations to feed patients now. That MS Lady would be fed if it was now (instead of the 70's)?

And the organ donations - who gets paid? The donor, the family, somebody else? I mean they aren't supposed to "sell" organs right?

Anyway, thank you very much!

P.S. I'm not going to code brown on ya.

reply to post by Binder


Binder,

I'm in the nursing profession as well, I own a medical staffing company that temps nurses to hospitals, nursing homes and med facilities. Over 10 years.

My questions to you are these (without violating HIPPA or patient confidence):


What is the funniest situation you've ever encountered?

What is the saddest situation?

Most disgusting?

What is the sexyist happening in you career, on the floor or CCU?


Hopefully this will be a sort of release/vent/therapy of sorts for you as well Binder..

reply to post by Nursejr


I apologize. Seems Nurse Binder concurred in a sense; sort of, but didn't complete the picture really.

You also said:

Nurses are mandated to give the SAME EXACT care to everybody, regardless of reimbursement. In other words, we are not allowed to change our level of care based on what the patient (or their insurance company) is going to pay.

But, in the 90's I was in the shock/trauma A - ICU almost 24/7 for 6 weeks tending a family member and noticed the black girl in the bed beside him (must have been a jane doe, no family ever came) had a wrist-tag that said "no pay" (unlike my family member's which said "self-pay".) Well, that black girl was never visited by a doctor nor did any of the nurses come except to change the bags and initial a chart once a day. She had a tumour on the back of her neck. Anyway, she was essentially neglected and after three or four weeks she gave up the fight and ended up on the meat wagon for spare parts.

I could go on, my family member was insured, then later there was an insurance snag (which eventually ended up in court and all cleared up because he actually WAS insured but he had paid the hospital off with several mil before the court case cleared up) ... but anyway, they changed his tag from self-pay to no-pay and stopped tending to him.

His temperature was 108 (I had learned how to exchange C reading to the F I understand) and I told the nurse and they were like *BIG SHRUG* - so, I spent most of my 6 weeks icing him down, then sleep two hours, then it was back up to 108 and I'd start all over and bring it down again. This went on most of the 6 intensive weeks. Over and over.

The air machine technician stopped coming except when I hollered for him specifically (because I knew where the readings were supposed to be between).

The therepist quit coming, so I did the exercises to keep his muscle tone.

I called for the doc when he went jaundiced.

Then kidney failure and blood in the bag. Nurses wouldn't call the doctor so I had to.

He went into triple failure (lung, liver, kidney) of ARDS in addition to the pancreatic failure he entered with. He entered with no blood (he had bled out and was air-vacced in a pressure suit). He had his pelvis crushed, hips broken in several places, aortic? rupture of an artery in the back to the heart, swan cath, ruptered all sorts of misc. goodies, legs and arms all broken in multiple places.

And I cannot credit one nurse for helping him. One nurse, a woman who at one time was almost my step-sister ... even said "Let Go!" She was declaring him dead when I and all the rest of my family knew he was going to make it. My baby brother DID make it ... but, as Nurse Binder explained ... some nurses and hospitals are just bad. And this one was the nation's #1 Trauma Center at that time!

And so they DO stop coming when they "think" it's a no-pay. They were paid in full in cash - not even insurance money. He was there another 6 weeks in a normal ICU.

So, during that period he actually WAS insured but insurance was claiming he wasn't - what would give those ANIMALS any logical reason to follow orders from a company they THOUGHT wasn't his insurance company (even though it was). I'm GUESSING from your reply that the INSURANCE no-coded him ... the same insurance who claimed he wasn't one of thier customers.

And hospital's take orders from the insurance company, rather than from the family-patient-doctor? This is plain wrong.

Why is it when you stay in a hospital, you are bothered by a constant stream of traffic coming into your room, you can't rest like that.

Bloodwork, blood pressure, people asking you questions. Why can't these efforts be consolidated a little?

When I had my son, I was interrupted so much that I coudln't nurse, it was very stressful. It got to the point where I begged to leave a day early (c-sec) just so I could sleep.

Hello!

Quick question on the Organ Donor. As far as I know, the MD's are volunteer. The facility costs are paid for by Organ Donor Organizations. (Kidney One in PA, for example). The donor pays nothing, the recepients pays nothing. There is even a built in system so that the donor and the people they help stay anon: unless BOTH parties agree to communication. And even then, it is mediatied through the Donor Organizartion.

My co-nurse makes soem good points on the medical/nursing staff. One of our jobs is to support the patient, and sometimes family, until death. Death and sickness know no holiday, vacation, or weekend. We in the medical/nursing field will care for you no matter what day it is. Yeah, we have our own family at home. Our own children would like to see us on their Birthday or to come watch thier first soccer game. But no, there are some who must come care for those who need it. Remember those who are working overnight, weekends, or that holiday that you and your family really enjoy.

And about the GP''s who are making about $100k a year, take home. Yes, in total they may net $1-2 million. But here is an ave breakdown of cost:

1,000,000
-75,000 for every RN in the office for salary (usually 4-5 = 300,000-375,000)
-50,000 for every non-RN staff (usually 2-3 = 100,000-150,000)
-8,000 for every employee's health Plan (48,000-64,000)
-80,000 for building costs (office space, utilities, etc)
-160,000 per year malpractice insurance (which, BTW, must be paid for at least 7 YEARS or more after retirement, depending on state of residence)
So far, that is $688,000 (on the low side) spent BEFORE taking into account taxes, etc.

So, yes, insurance companies are taking a big chunk of profit. But isn't that their job? To make money?

If you don't like it, than pay the bill yourself. FYI, nearly every healthcare facility gives a discount for paying cash. Ask any hospital that caters to the Amish. Heck, all the surgery centers I have worked at give a 30% discount off of the TOTAL bill for cash payers. But of course, as per my first post, you are paying for Ferrari care, as mandated by law. (See JCAHO, Medicaid, etc)

Now before I get the Newbie flames, let me explain my position. I am not soem nurse venting about how bad i am treated. I am simply giving a point of view from somebody who KNOWS the system is broken yet still works in it and will give anybody any tip or trick I can so they can navigate more safely in the healthcare field.

Our job is to care for and protect our patients. No matter what.

So, one final thought: Are you the type of person who blames the waiter for bad food or the cook?

Again, thanks for reading,

NurseJR, John

Just a quick comment for the night regarding the No Pay story. Not to sound cruel or mean. But would you offer your house to somebody when you know they couldn't pay the rent? I mean, isn't housing a right? How often do you give food to someone who has no money? And if you do, how long would you do it? I mean, isn't food and shelter basic human rights?

All I ask is to put yourself into the insurance/hospital's shoes for a while. Proven research tells you not to smoke, and when you get lung cancer, COPD, mouth cancer, etc and STILL smoke, why should everybody else help pay for your own choices?

If you eat so much that the ambulance team has to cut you out of your house to get you to the hospital for an infected foot (true story), why should the other people/companies pay for your healthcare? And yet, we still care for you.

There are a thousand stories of bad care out there, including my own after an auto accident. But there are millions more out there of people's lives becoming better because of good nursing care.

Thanks gain for reading and giving ME insight.

John

reply to post by dbloch7986


The first year or two I was a nurse I was sick as heck a lot of the time. It was a combination of stress, and exposure. Now after a decade in, you're right I hardly ever get sick. The immune system is an awesome thing. We also have to get all sorts of immunizations, and have titers drawn to make sure we are still immune to a lot of the real common junk.

The first couple of years of nursing really is hell on earth. you are the new guy, and the old rule "FTNG" rules in nursing too. I am a very senior member of my team now, and I watch out for the new kids. There is an old saying that nurses eat their young, and unfortunately it is all too true. I don't plan on ever having that said about me. I have a friend who was a combat marine in Vietnam, and he said there are days on the unit that he misses Saigon!

reply to post by Trexter Ziam


I know what you are getting at, and I have seen it. I am truly blessed to work in a facility that is not profit driven so I do not see it often. We have other funding issues, but continuation of care is not one of them. As far as the black girl in the room next to you. Without a lot more intimate knowledge of what was going on there I really can't speak to that. A lot of times things are not as they seem..., and sometimes unfortunately they are. It sounds like you had a really bad experience, and I am sorry. It isn't supposed to be that way, but as Nursejr said we work in a broken system, and you do the best you can. sometimes a whole facility does adopt a poor environment of care, and that is a terrible thing. I too believe that basic, life sustaining care should not depend on your ability to pay. However, on the other end of that spectrum. It would be fiscal suicide for a hospital to get organ transplants for every drug abuser, and alcoholic that comes in the door. We do see a lot of people who's conditions are the result of their own doing. If you are likely to undo yourself again, no we are not going to go to heroic, and massively expensive measures to save you so you can go get bombed out of your head again, and throw it all away. But, people who are sick, and just aren't in a position to pay, or have good insurance should still get decent healthcare, not Ferrari health care, but decent. unfortunately at the end of the day healthcareis a business, and if it goes out of business, no one gets healthcare. The greed, and corruption sometimes present is a product of the human condition because humans still run the system.

reply to post by nixie_nox


This is probably the most common complaint I hear. It was also my biggest compaint when I was in the hospital a few years back. The short story is that a hospital is a terrible place to come to rest. They are busy, busy places 24-7.

Believe it or not nurses do, or at least should try to make these interruptions minimal. It is called cluster care. I try to wait on meds, or procedures etc... until another team like lab, or respiratory, or physical therapy is also rounding, and do everything at once so you get one big interruption instead of four, or five, or more. It just doesn't always work out though.

The medical staff at a hospital has to not only get all the info they need to develop a plan of care, execute that plan of care, examine the results of that plan of care, and take care of you physically, and emotionally, but we have to document every jot, and tittle of everything we did, how you responded to it, and how we are going to follow up. We have to do it for your neighbors in the next room too.

Also had you had a complication like hemorrhage, or dehissance you would have been very grateful for all those interruptions. We are legally, and ethically charged with your safe keeping while under our care. We have to document like there is a judge, and jury reading every word because if you nurse long enough eventually there will be. We have to keep close tabs on how you are doing.

As far as information gathering. I will agree with you there. Most hospitals order of service has you answering the same question a hundred times. It is one of my pet peeves too. Sometimes we have you repeat an answer to different people several times to make sure the story is straight kind of like an investigation, but most of the time it is just poor interdisciplinary communication.

Originally posted by paratus
reply to post by Binder


What is the funniest situation you've ever encountered?--

I had to think about this one awhile there's been a lot. I'll share about how my very good friend(we'll call her Jane) got her nickname. I was helping Jane turn a ventilated patient, so they wouldn't get skin breakdown. This guy was HUGE, like 500+ lbs, and he was about 5'4". Jane is a very short, petite woman, maybe 110 lbs dripping wet. I was holding the guy over while she was checking him for breakdown, and arranging his bed chocks for his new position. Just as she went in for a closer look at the old backside this guy lets loose with a GI hurricane. Poor Jane caught the full brunt, her hair was blowing around, and I think I even saw her ears flap a little. So, we finished up, both of us laughing(after she felt it safe to breathe again.) walk out of the room and were washing our hands. I got a good close look at her face as we were bent over the sink together. I said "OMG Jane go look in the mirror!" as she did so she turned white with horror. Jane had freckles for the first time in her life. So now anyone who doesn't know wonders why we call a girl with not a single freckle "freckles."


What is the saddest situation?--

When I was a circulator in surgery a teenage girl went into DIC during a routine surgery. We couldn't stop it. We had to take her back to her single father, and tell him his only daughter had about 6 hours left to live. The man screamed, and passed out, and we thought we were about to code him too. I have 4 children myself. That man's experience still haunts me.

Most disgusting?--

I watched a guy crap his own dead bowels out. He spent over a year in ICU in a persistant vegetative state, the family refused to let him go, and he rotted to death. Luckily I truly believe his soul had already been in a better place for quite some time.

What is the sexyist happening in you career, on the floor or CCU?--

Well I met my wife during my career, and she is also a nurse. Lots of sexy stuff happens on the floor, but never in CCU.


Hopefully this will be a sort of release/vent/therapy of sorts for you as well Binder.. --

Thank you paratus, yes it is nice to be asked about my personal experiences, and how they have affected me, very thoughtful.

Here is a good one.
Why can i not get a straight answer out of doctors.
By the way i was a EMT for over 30 years.

In early 2002 i woke one morning feeling like a 18 wheeler ran over me. and it has never went away.
They spent 14 months without coming up with a cause. and during that time i could not sleep but about 6 to 8 hours every third night. and being able to work is becoming imposable
June 2003 they did a CT scan(looking for neoplastic disorder) and found a enlarged lymph node(5+mm) in my chest and removed and biopsied it as Hyaline Vascular Variant of Castlemans Disease. but the pathologist never did a staining of the tissue slides or take any photos of the slides. (or never recorded it if he did)
2004 go in for a followup CT scan and they find a number of 2 to 3 mm lymph nodes and run a lot of lab test.
DX Sarcoidosis then when these doctor can not review the old pathology slides then claim i never had Castlemen's disease.
But when i ask for a explanation they can not give me a clear answer.
In years of searching case studies on the internet i only find two other cases of people having both Castleman's and Sarcoidosis. Both are rare autoimmune diseases and having both would be very very very rare.

About this same time they DXed the severe body wide pain as fibromyalgia but give me nothing for the fibro telling me my primary care would give me meds for it. (this was a professor of rheumatology from UCLA)
I see my primary care doctor and he does not believe in fibromyalgia. (this doctor was a contract doctor from a HMO working for the VA under contract) I fired this doctor and ask for another one.(don't mess with a EMT)
The new doctor gave me amitriptyline and after three months no pain relief. doctor tells me to keep taking it and it will start working.
After 6 months i tell the doctor its still not working and i am getting a lot of side effects.
This doctor tells me that i have to keep taking it as it is the only medication for fibromyalgia and it will work with time. I fire this doctor. because i am Internet wise and have done my research.
Get a new doctor and ask for Gabapentin or Vicodin (i knew they would not give me vicodin) got gabapentin (I had already tried some bootleg Gabapentin and knew it would work and i had got some vicodin after some dental work and knew it also worked) plus i wanted the Gabapentin anyway but would not tell the doctor that.

At the same time i am trying to get the Gabapentin I ask for a sleep study for sleep apnea.(80% of people with fibro have sleep apnea) at first the doctor does not want to refure me but i insist.(he my have read in my records where i had fired two doctors before him)
Get the sleep study and it finds i have severe sleep apnea. severe primary RLS and Periodic Limb Movement Disorder (PLMD)(no faking that if you are sleeping.)
Gabapentin also works for RLS and PLMD. one drug to treat three disorders.
The sleep study doctor sends me to a neurologist because he has seen this before. They find peripheral neuropathy that was being hidden by the fibromyalgia pain
About this time(mar 2006) i have a heart attack and walk into the VA hospital ER and tell them i am having a heart attack
The Intern did not believe me at first because i was not having chest pain or shortness of breath.(did have left arm cramping, burning under the chin, neck and across the tops of my shoulders(angina) and profuse sweating.my EMT training said atypical heart attack!!!) he puts the leads (EKG)on me and gets a Surprise i go straight to angioplasty with a 95% blockage.
Got a angioplasty and a C-pap that night and 12 days later 5 way bypass surgery.
Been on the C-pap ever since as the sleep apnea was likely the cause of the heart attack.

2008 get DXed with diabetes.

Since then i still have doctor treat me like a hypochondriac. Yet i have been right most of the time when i come in with a problem(over 85 % record of being right )
Don't read my medical records and try to tell me my neuropathy is caused by my diabetes.
Try to tell my i never had Sarcoidosis even though its outside there medical specialty.
Since i have been under the care of the VA every VA doctor has my complete medical record at the click of a computer keyboard. yet i have to correct them all the time and give the month and year of when things started.
they treat me as a drug seeker and its almost imposable for me to get even vicodin when i really need it.
but they have no proof what so ever that i am a drug seeker and in fact i only would use Vicodin or any other narcotic only when i absolutely need it and only for as long as absolutely. (my dentist(non VA) gives it out like candy and i save whats left for when i .absolutely need it.for severe neurological pain )

I would hate to be someone that has parts of there medical record at at different hospitals

The biggest thing i am glad of is my training as a EMT 35 years ago and that i kept up the training for all those years.

And the biggest heartburn for my doctors is i was a EMT for all those years because i understand when something is wrong and get it checked out. I also understand when i am getting bogus answers.