Wednesday, October 24, 2012

Surprising twist

In a surprising turn of events, all of my allergy skin testing yesterday was negative. I was negative for all 69 triggers that they tested. The doctor was baffled and I was [pleasantly] shocked. My clinical picture very much pointed towards allergies being the culprit for a lot of my generalized 'yuck'. That said, after some pulmonary function tests and a significant improvement post administration of albuterol, I was given the [equally] surprising diagnosis of "asthma / an asthma spectrum breathing issue" and a 1 months sample of asthma management drugs to see if there is any improvement.

The doctor also discussed emerging research supporting local IgE response in both the nasal tract and gastric mucosa- which would mean that one is actually allergic to something but that there is no way to easily test for it as there will be no response to skin or blood testing. Local IgE?! This challenges everything I learned in immunology... given immunology was the pre-clinical class I struggked most with.  However, reviewing some scholarly articles on the subject today proves him right, that this is an emerging belief in the allergy and immunology world. They have no way to test for these triggers and so I may never know if this is in fact what is going on with me. Maybe I actually am allergic to something(s) (which I suspect to include dust and mold) or maybe I'm just a paranoid hypochondriac? 

Tuesday, October 23, 2012

Health care blues

We had a discussion yesterday on the Affordable Care Act and how it affects women's health care, especially contraception.  I left the talk totally depressed.  This was further amplified by watching the 3rd presidential debate last night. 

I recognize that the ACA is not perfect, but it is a HUGE step towards affordable and comprehensive health care in this country. I believe that health care is a right, not a privilege.  I also know that we can not continue to afford the rising cost of health care as we can't even currently afford it.  I'm sickened by the fact that politicians play political chess with people's health.  I can not understand that level of disregard for another humans welfare; but I guess that is why they are politicians and I'm a (future) health care provider.

In the discussion yesterday, we were shown a slide from the New England Journal of Medicine article "A watershed election for health care (2012)".  The chart dives up the likely results to the ACA depending on the election outcomes.  It is no shock that Romney winning would be a very large step back for health care in the US (a long with LGBT rights, abortion rights, and so many other things), but what did give me pause was what happens if Obama is reelected with a republican house and senate.  "Maintenance of near pre-ACA levels of uninsured Americans; no substantial growth in levels.  Less aggressive implementation of ACA health system provisions".  Shit.  So basically more political chess with people's lives at stake.  Nothing will be accomplished, will still be stuck in the middle of nowhere.  Lovely.

Needless to say, I'm very worried about this election.

I am also so grateful to be an insured American with unlimited access to quality care. This year off from medical school has been full of many more doctors' visits than I would have imagined. After the horrible car accident with trip to the emergency room this summer, I'm now dealing with a whiplash, a pinched nerve (upper trunk of my brachial plexus), and radiculopathy. Weekly chiropractor appointments in attempts to fix that. I'm also finally address my chronic anemia, fatigue, and constant general yuckyness by figuring out the trigger. A round of visits to a GI and a abdominal CT have ruled out my celiac as the culprit. [Even if I did read my CT as having a "speckled colon and a titled uterus" - thankfully a radiologist who actually knew what he was reading righted my incorrect paranoid diagnosis.] Good to know that I'm not being accidentally glutened. The GI's answer to this was that I'm probably allergic to something (or many somethings) and so I should take a low level steroid to blunt my immune system. Um, no thanks. I'd rather just figure out what the cause is so that I can avoid it. So, today I am finally getting much need allergy testing. Thank G!d that my comprehensive trusty health care insurance is along for the ride.

Thursday, October 4, 2012

Voting for Big Bird

Last night's presidential debate was awful.  Romney was totally charismatic in an absolutely condescending way.  I couldn't decide if I wanted to hug him, or slap him.  I also kept imagining a thought bubble of loose associations over Obama's head.  I am not sure where he was but he clearly was not present at the podium. 

There were nonsensical sentences.  There were long run on thoughts that led in a circular manner towards nowhere. There were lies and empty promises followed by more lies.  The discussion was harder to follow than those of my floridly manic patients when I was on my psych clerkship!

There was one sentence in particular that sat very poorly with me though: "I would like to take the Medicaid dollars that go to states and say to a state, you're going to get what you got last year, plus inflation, plus 1 percent, and then you're going to manage your care for your poor in the way you think best."  Let us just quickly look at two case examples.  Alabama wants to take care of their poor by using medicaid as the sacrificial lamb for their budget issues.  Louisiana took care of their poor by cutting $329 million from their state healthcare, and by closing one of the state's 3 psych hospitals, likely adding more strain to the hospital and jail structure.   Two shinning examples of how one should take care of valued citizens.  I totally feel confident that allowing states to have sole decision making power on the nations healthcare will solve all our finical issues and improve the health of ever individual American... Not.

I'm voting for Big Bird.  I'm voting for ObamaCare.  While not perfect, it is a start.  I have to believe in something.