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Providing non-judgmental and non-criticizing support for family and friends of end-stage alcoholics through one-on-one coaching, support groups, blog posts, workshops and public speaking.

Monday, February 6, 2012

Alexandra's story...

Today I got an e-mail from one of my followers who had an interesting story to tell. She relates a recent visit to an emergency room in her area. It’s just another example of how the medical community fails to understand “end-stage” alcoholism and how they can help rather than see these patients as “throw-away” people.
This is Alexandra’s story:

I had quite an eye-opening experience at the ER today. Donald is my alcoholic "friend" and he is 50. His alcoholism is progressing and until last week he was still very functional. He was diagnosed with chronic calcific pancreatitis a few months ago, when he went to the ER in great pain. He's on Medicaid and goes to the local clinic where all the other Medicaid patients go and they were supposed to refer him to a GI doctor but never did.

Donald has pretty much stopped eating as of last week. He stopped bathing and changing his clothes. He's very confused when he's drinking and asks the same questions over and over. Some of his questions are getting quite nonsensical.

Last night he stepped on something in his room and cut the bottom of his foot. There was blood but he didn't show it to me until this morning and it had stopped bleeding by then but since he has diabetes, I told him maybe a trip to the ER would be a good thing because maybe he needed some stitches. I thought they could clean it up put in a stitch or two and properly dress it with bandages. I also hoped for a shot of antibiotic.

So I dropped him off at the ER door and went to park the car. When I got inside, he was telling the nurse that he had been ice fishing and fell through the ice and cut his foot! I shook my head and told the nurse no, that's really not what happened. Donald looked at me and said "It's not?" He was dead serious. I had heard of the guessing that alcoholics do when they can't really remember stuff but had never seen it in him this bad.

Then the doctor came in. I told the doctor he cut his foot, and that he was also losing weight, was having a lot of shakes and confusion and was throwing up a lot, etc. I also told the doc Donald had been diagnosed with pancreatitis. The doctor asked me if he was still drinking and I said yes.

I could see a look of disgust come over the doctor's face; it seemed as if, all of a sudden, Donald was a total waste of his time. The doctor told me that as long as he was still drinking his pancreatitis would get worse. He then barely glanced at Donald's foot and said to the nurse "just clean it up, put a Band-Aid on it and get him out of here," then he turned and left the room.

Then it was the nurse's turn. She said to me that he needs to stop drinking (Duh!) and that I shouldn't buy him anymore alcohol. I told her I don't buy it, that he goes and gets it himself. The nurse responded with he shouldn't be driving and I said that he doesn't drive, he walks! Then she said that lots of people have quit drinking, I should just "make" him stop and "all that happens is that they just get the shakes for a couple days and then they're ok."

I was just floored. She left the room. Both the nurse and the doctor had Donald just lying there with his shorts on and didn't even get him a blanket or gown. They knew he has diabetes, didn't bother to check his blood sugar.

Donald wanted to leave. I agreed since it didn’t seem that they were going to do anything for him anyway. He struggled to get his clothes back on and we left. No one seemed too concerned.

I just couldn't believe the callousness of that doctor and nurse. I realize the people in the ER are overworked but to just blow off someone just because they have an addiction is so sad. I wanted to get that doctor back in there and have him take a good look at Donald lying there all yellow and skinny and ask him "DO YOU THINK HE WANTS TO BE THAT WAY?"
It's sad to me that a doctor and nurse would think that alcoholism is so easily stopped and all someone has to do is stop drinking and that will be the magic bullet for this disease.

Unfortunately Alexandra’s story is not so unusual. Our medical community should treat all patients with the idea that they will help do what they can do. In this case, his foot needed to be examined and treated. It shouldn’t have made any difference that he had been drinking. Of course, we all understand that if he doesn’t stop drinking, he will continue to digress. But, that doesn’t mean he should get an infection in his foot and left with a new problem to be faced.
I understand that doctors want are in the business of saving the lives of people who want to be saved. I understand their frustration. All end-stage caretakers feel that frustration acutely. We should not be treated as though we don’t know what’s going on. Believe me. We all know exactly what’s going on.

If I had breast cancer and had cut my hand while washing dishes, should my hand be treated in spite of the fact that I may not live three more months. Of course it should. Why should it be any different for a person dying of any other malady?


Gerry said...

I think this entry is so on target. I live in a large HUD housing complex where addicted people abound. Believe me, the obesity epidemic is here. Will that emergency doctor express the same disgust when an obese person comes into ER with some addiction related problem? Pierre's pancreas had also nearly calcified and when he had an attack he was in excruciating pain. Yes, he contributed to the problem with his alcoholism, but he also smoked and eventually he would develop lung cancer which killed him before the alcohol did, as it killed my father with emphysema. He was having to go to a hospital every time he binged on alcohol because his lungs would fill up with fluid due to his emphysema, so two of his addictions were at work here! One obese friend I had here had asthma which was greatly exacerbated by her weight gain. As every ailment is. Obese people are going to cost whatever system is paying their insurance most likely medicare and medicaid up to millions before they are through and because of burgeoning weight are going to be extremely hard to treat. Probably most ailments are worsened by some kind of addiction, so the doctor and nurse in that ER had bad attitude problems and probably should not even be in the business. I have had ER people who were extremely impatient with my phantom disease, chronic fatigue syndrome and I do not smoke or drink! And am over weight but not obese.

Karen E. said...

Im sorry Alexadra..its just too sad. We have a similar experience. My mother 70 yrs old has ben in and out of rehab and hospitals stays for yrs..in other words i her records doctors se her problem. Last June she fell and hurt her arm. At 4 am i took her to the ER, she was toasted of course. The took her to Xray, er doctor said no fracture..she will be fine. sent us home, no sling, nothing. 3 days later I made appt with her orthopedic that had treated her previod.usly for same arm, same reason.. They had the xray taken in the ER, the radioligist report says fracture..ER doc jut ignored it. She was in a cast for 8 weeks... sa

ADDY said...

It is exactly the same here in England and I have written about it before when exactly the same happened to Greg. Medics here just raise their eyes heavenwards as soon as they know alcohol is involved. Greg once pulled off two toenails (they had grown so long and he did not cut them) and when we went to A&E they just ignored them! I do feel doctors need more than the small amount of teaching they get on alcoholism to deal with what is an increasing problem here..

Syd said...

I feel for Alexandra and her friend. I also know that it is up to us to speak up to the doctors and nurses. I believe that we can help educate them by saying that this person needs to be looked at further. There isn't some mythical god treating you--it is a doctor and some are better than others. Speak up about your care or the person you are caring for. If we don't ask for what we need from the medical establishment, nothing will change.

The Immortal Alcoholic's Wife said...

Syd -- I agree wholeheartedly. We must be specific about what we want and insist upon being treated for the immediate need. We also must be educated so that we know what we need to ask for. Alcoholic or not -- we can't go around just taking a medical person as the be all and end all of knowledge. We must have a voice and use it loud and clear.

Gerry -- I have seen this happen with obese people as well. If you have stepped on a nail and need a tetnus shot -- it must have been because you are obese. At least that's the way it feels.

Gabriele Goldstone said...

That's just so wrong - ignorance has nothing to do with intellect or education. My future frightens me. I was raised on shame and I am ashamed of my alcoholic's addiction BUT ... these are medical professionals, not Baptist pastors!

ADDY said...

Hi. hope you don't mind but I have just done a post linked to this. Maybe one day the professionals will learn from our experience!

Furtheron said...

Great post - I came via Addy... It is very sad that this is the 21st century and still this is how sick people are treated

Linda (The Immortal Alcoholic's Wife) said...

Addy -- Thanks for the link. You can always use anything on my blog. I'm all for anything that helps generate a more "caring" environment with the medical community.

tieropasvmii said...

My ex just died this past Sunday from alcoholism. The doctor apparently said he had no insurance and he was an alcoholic (with ascites and most likely varices, kidney and liver complications, couldn't pee or poop) so he needed to just leave. Tried to kick him out a day before he died but his grandma refused. When he coded, either from bleeding varices or a rupture somewhere (possibly esophageal), it took paging code blue 14 times before the doctors walked in, laughing to each other. Just walked in, no hurry at all. Why hurry? Just another worthless alcoholic who won't live the next month to see his 30th birthday.